不同剂量锌治疗轮状病毒性肠炎患儿的疗效分析

Efficacy of Different Doses of Zinc in Children with Rotavirus Enteritis

背景世界卫生组织（WHO）推荐5岁以下急性或慢性腹泻病患儿口服锌制剂治疗腹泻,6个月以内患儿每日补锌10 mg,6个月以上患儿每日补锌20 mg,连续10～14 d。WHO推荐的腹泻病补锌制剂量超过儿童日常补锌制剂量的2倍,此剂量是否过大,对患儿是否合适,目前尚无相关报道。目的探讨不同剂量锌治疗轮状病毒性肠炎患儿的临床疗效。方法选取2011年1月—2013年7月在石岩人民医院儿科住院的轮状病毒性肠炎患儿163例,采用随机数字表法分为3组,对照组57例给予常规治疗;低锌组51例在常规治疗的基础上给予葡萄糖酸锌颗粒0.5 mg·kg^-1·d^-1,分2次口服;高锌组55例在常规治疗的基础上给予葡萄糖酸锌颗粒口服,剂量为年龄≤6个月给予10mg/d,年龄〉6个月给予20 mg/d,分2次口服,均连服14 d。比较3组患儿临床疗效及腹泻、发热、呕吐持续时间。结果 3组患儿临床疗效比较,差异有统计学意义（H=23.34,P〈0.001）;低锌组和高锌组临床疗效优于对照组（P〈0.05）;低锌组与高锌组临床疗效间差异无统计学意义（P〉0.05）。治疗后3组患儿腹泻、发热、呕吐持续时间比较,差异均有统计学意义（P〈0.05）;低锌组和高锌组较对照组腹泻、发热持续时间均缩短（P〈0.05）,低锌组与高锌组腹泻、发热持续时间差异无统计学意义（P〉0.05）;高锌组呕吐持续时间较对照组和低锌组延长（P〈0.05）,对照组与低锌组呕吐持续时间差异无统计学意义（P〉0.05）。结论补锌治疗轮状病毒性肠炎患儿疗效显著,可缩短腹泻及发热病程,但大剂量补锌可能延长呕吐持续时间。

Background According to the world health organization（ WHO） recommendation,children under 5years with acute or chronic diarrhea should take zinc orally zinc,children under six months take 10 mg zinc daily,children above six months take 20 mg zinc daily,the treatment should last for 10 ～ 14 d. The zinc supplementation dose recommended by WHO is2 times more than children＇s daily dose of zinc supplementation. At present there is no relevant reports about whether the zinc supplementation dose recommended by WHO is too large or not,and whether it is appropriate for children or not. Objective To investigate the clinical effects of different doses of zinc in children with rotavirus enteritis. Methods 163 children with rotavirus enteritis who were admitted to department of pediatrics in Shiyan People＇s Hospital from January 2011 to July 2013,were selected as study subjects,the cases were divided into 3 groups by random number table method,57 cases in the control group were given conventional treatment,51 cases in low dose zinc group were given conventional treatment and zinc gluconate granules（ 0. 5 mg·kg^-1·d^-1,take orally for two times）,55 cases in high dose zinc group were also given conventional treatment and zinc gluconate granules（ children ≤ 6 months were given 10 mg / d, children 〉6 months were given 20 mg / d, take orally for two times）. The zinc treatment lasted for 14 d in low dose zinc group and high dose zinc group. The efficacy,duration of diarrhea,vomiting and fever were compared among the 3 groups after treatment. Results There was significant difference in efficacy among3 groups（ H = 23. 34,P〈0. 001）. The efficacy in low dose zinc group and in high dose zinc group was significantly better than that in control group,respectively（ P〈0. 05）. There was no significant difference in efficacy between low dose zinc group and high dose zinc group（ P〉0. 05）. There were significant differences in duration of diarrhea,vomiting and fever among 3 groups after treatment（ P〈0. 05）. The duration of diarrhea and fever in low dose zinc group and in high dose zinc group were signifi-cantly shorter than those in control group（ P〈0. 05）. There was no significant difference in duration of diarrhea and fever between low dose zinc group and high dose zinc group（ P〉0. 05）. The duration of vomiting in high dose zinc group was significantly longer than those in low dose zinc group and control group,respectively（ P〈0. 05）. There was no significant difference in duration of vomiting between low dose zinc group and control group（ P〉0. 05）. Conclusion The efficacy of zinc supplementation in children with rotavirus enteritis is significant,zinc supplementation can shorten course of diarrhea and fever,but large dose zinc supplementation may extend the duration of vomiting symptoms.