孕晚期妇女服用钙及维生素D初步观察

Effect of calcium and vitamin D supplementation during late pregnancy

目的 观察孕晚期妇女服用钙及维生素D对孕期妇女低钙和维生素D缺乏的效果。方法 对 2 4例孕 2 8周后的晚期妊娠妇女 ,每日服用碳酸钙加维生素D 1片。并与同期 11例不服任何钙剂及维生素D3 的晚期妊娠妇女 (对照组 )进行比较。结果 (1)用药组产前血清钙 (Ca)、磷 (P)、骨钙素 (BGP)及 2 5羟基D3(2 5OHD3)明显高于用药前的孕 2 8周 (P <0 0 0 1) ;而对照组产前与孕 2 8周比较无明显变化。 (2 )给药组产前尿羟脯氨酸与肌酐比值 (HOP/cr)、尿钙 (Ca)与肌酐比值 (Ca/cr)比孕 2 8周明显减少。 (3)尿中Ⅰ型胶原交联C末端肽与肌酐比值 (crosslaps/cr)给药组 ,和对照组在产前明显高于孕 2 8周 (P <0 0 0 1) ,但产后 42天 ,给药组明显低于对照组 (P <0 0 0 1)。 (4 )两组血清碱性磷酸酶 (AKP)产前明显均高于孕 2 8周时水平 (P <0 0 0 1) ,表明胎盘产生大量AKP。结论 孕期服用碳酸钙加维生素D3 有明显促进骨形成 ,抑制骨吸收的作用和提高血清钙、磷的作用。给药 8～ 10周后 ,虽然 2 5OHD3 比治疗前有明显升高 ,但仍低于同年龄健康妇女的水平 ,提示对孕产妇应适当增加维生素D3 的用量。

Objective To observe effect of Calcium carbonate and vitamin D supplementation on pregnancy women.Methods Supplement Group:24 late pregnancy women had taken Caltrate D(1 tablet/day)from pregnancy 28 weeeks to parturition.Control Group:11 late pregnancy women had taken no calcium and vitamin D supplementation at the same time.Serum Ca,P,AKP,BGP,25(OH)D 3,urinary HOP/Cr,Ca/Cr and crosslaps/Cr were measured.Results (1)In Supplement Group serum Ca,P,BGP,25(OH)D 3 were higher significantly before parturition than one before pregnancy 28 weeks.However,in Control Group there were no significant change.(2)In Supplement Group urinary HOP/Cr and Ca/Cr were decreased significantly after supplementation.(3)Urinary crosslaps/Cr in Supplement Group was lower significantly than one in Control Group on 42 days after parturition.(4)In both groups serum AKP were higher significantly before parturition than one before pregnancy 28 weeks.Conclusions Calcium carbonate and vitamin D supplementation can significantly promote bone formation,press bone absorption and increase.Serum Ca and P during pregnancy.