| 摘要: |
| 目的：探讨药物联合行为干预治疗维生素D缺乏的疗效，为临床治疗维生素D缺乏提供参考。方法：选取2017-2018年在我院接受健康体检的610例儿童（3个月~3岁），检测外周血中25-羟维生素D［25（OH）D］水平，并根据25（OH）D水平将所有研究对象分为维生素D缺乏组（n=60）和正常组（n=550）。分析维生素D缺乏的影响因素，制定行为干预手段。将维生素D缺乏组按随机数字表法分为行为干预组（采用行为干预+维生素D滴剂和葡萄糖酸钙锌口服溶液治疗）和常规治疗组（采用维生素D滴剂和葡萄糖酸钙锌口服溶液治疗）各30例，比较行为干预组和常规治疗组临床疗效及治疗前后骨代谢相关指标水平变化情况。结果：喂养方式、户外活动时间、厌食、腹泻与维生素D缺乏具有相关性（P<0.05）。Logistic回归分析结果显示，喂养方式、户外活动时间、腹泻是维生素D缺乏的独立影响因素（P<0.05），普通奶粉或其他喂养方式、户外活动时间<2 h/d、经常腹泻患儿更易发生维生素D缺乏。治疗前，行为干预组与常规治疗组25（OH）D水平及骨代谢相关指标差异无统计学意义（P>0.05），治疗2个月后，行为干预组25（OH）D、血钙、血鳞、骨钙素水平高于常规治疗组，骨碱性磷酸酶（BALP）低于常规治疗组，差异有统计学意义（P<0.05）。结论：在药物治疗的基础上，联合针对喂养方式、消化道功能及户外活动时间等制定的行为干预，可提高治疗维生素D缺乏患儿的临床疗效，改善骨代谢指标。 |
| 关键词: 维生素D缺乏 药物治疗 行为干预 |
| DOI：doi:10.13407/j.cnki.jpp.1672.108X.2020.12.009 |
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| 基金项目: |
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| Effects of Drug Therapy Combined with Behavioral Intervention on Bone Metabolism Related Indicators in Children with Vitamin D Deficiency |
| Yang Xinfeng, Wang Huirong, Hu Yixing, Deng Juan, Yang Jie |
| ((The General Hospital of Central Theater Command, People’s Liberation Army, Hubei Wuhan 430070, China)) |
| Abstract: |
| To probe into the efficacy of drug therapy combined with behavioral intervention in the treatment of children with vitamin D deficiency, so as to provide reference for the treatment of vitamin D deficiency in clinic. Methods: A total of 610 children (from 3 months to 3 years old) who underwent the physical examination in our hospital from 2017 to 2018 were selected to detect 25-hydroxyvitamin D (25(OH)D) level in peripheral blood. According to the 25(OH)D level, all children were divided into the vitamin D deficiency group (n=60) and the normal group (n=550). The influencing factors of vitamin D deficiency were analyzed, and behavioral interventions were developed. The vitamin D deficiency group was divided into the behavioral intervention group (behavioral intervention + vitamin D drops and calcium gluconate zinc oral solution) and the conventional treatment group (vitamin D drops and calcium gluconate zinc oral solution) according to the random number table, with 30 cases in each group. The clinical efficacy and changes of bone metabolism related indicators before and after treatment in the intervention group and the conventional treatment group were compared. Results: Feeding patterns, outdoor activity time, anorexia, diarrhea and vitamin D deficiency were associated (P<0.05). Logistic analysis showed that feeding patterns, outdoor activity time and diarrhea were independent influencing factors of vitamin D deficiency (P<0.05). Children with ordinary milk powder or other feeding patterns, outdoor activity time <2 h/d, frequent diarrhea were more likely to have vitamin D deficiency. Before treatment, there was no significant difference in 25(OH)D level and bone metabolism related indicators between the behavioral intervention group and the conventional treatment group (P>0.05). After 2 months of treatment, 25(OH)D level, serum calcium, squamous and osteocalcin in the behavioral intervention group were higher than those in the conventional treatment group, and bone alkaline phosphatase (BALP) was lower than that in the conventional treatment group, the difference was statistically significant (P<0.05). Conclusion: On the basis of drug treatment, behavioral interventions combined with feeding patterns, digestive tract function and outdoor activity time can promote the clinical efficacy of vitamin D deficiency and improve bone metabolism related indicators. |
| Key words: vitamin D deficiency drug treatment behavioral intervention |
