罗钙全与磷酸盐合剂治疗X-连锁低磷性佝偻病的剂量探讨

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对42例1个月至12岁健康儿童(C组)及9例2~11岁X-连锁低磷性佝偻病(XLHR)患者,于治疗前后采用全自动生化分析仪测定其血钙(Ca)、磷(P)、碱性磷酸酶(ALP),并计算其钙磷乘积(Ca×P)。将XLHR患儿分为A、B两组,A组采用传统治疗,主要给予中性磷酸盐合剂,辅以维生素D制剂不规则治疗;B组联合给予罗钙全[1,25(OH)2D3]及磷酸盐合剂规则治疗;两组观察时间为3~12个月。结果显示,A、B组治疗前的血Ca、P及Ca×P均显著低于C组,ALP显著高于C组(P<0.001),A、B组间各项指标均无差异(P>0.05)。治疗后半个月,B组较A组血Ca、P及Ca×P均显著升高(P分别<0.05、<0.01、<0.001),ALP显著降低(P<0.05),且B组X线片示骨密度较A组明显进步;治疗后3个月时,B组Ca×P已达正常范围,而A组最高值仅为2.53[正常3.2~5.0](mmol/L)2。提示:①XLHR患儿较健康儿童钙磷乘积降低2~3倍,因此骨骼不能矿化;②罗钙全30~40ng/(kg·d)及磷80~100mg/(kg·d)治疗XLHR短期效果好,未出现副作用;③罗钙全的治疗机制可能为? 42 healthy children (C group) from one month to 12 years old and 9 X-linked hypophosphatemic rickets (XLHR) patients aged 2 to 11 years were measured before and after treatment by automatic biochemistry analyzer. , Phosphorus (P), alkaline phosphatase (ALP), and calculated the calcium and phosphorus product (Ca × P). The children with XLHR were divided into two groups A and B. The patients in group A were treated with traditional therapy and were given neutral phosphate, supplemented with irregular treatment of vitamin D. The group B was given Luo calcium [1,25 (OH) 2D3 ] And phosphate mixture rule treatment; two groups observed for 3 to 12 months. The results showed that the levels of Ca, P and Ca × P in group A and group B before treatment were significantly lower than those in group C and ALP was significantly higher than those in group C (P <0.001). There was no significant difference between group A and group B (P> 0.05). Half a month after treatment, the levels of Ca, P and Ca × P in group B were significantly higher than those in group A (P <0.05, <0.01, <0.001, P < 05). The bone mineral density of group B was significantly improved compared with that of group A. At 3 months after treatment, Ca × P in group B reached the normal range, while the highest in group A was only 2.53 [normal 3.2 ~ 5.0] (mmol / L) 2. Hint: (1) The calcium and phosphorus products in children with XLHR were reduced by 2 to 3 times compared with those in healthy children, so the bones could not be mineralized. (2) The treatment of XLHR with 30-40ng / (kg · d) of total calcium and 80-100mg / (kg · d) The effect is good, no side effects; ③ Luo calcium treatment mechanism may be?
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