维生素D用药剂量对新疆地区不同民族维生素D缺乏症患儿的作用影响

Effects of vitamin D dosage on children with vitamin deficiency in different ethnic Groups in Xinjiang

目的研究维生素D用药剂量对新疆地区不同民族维生素D缺乏症患儿的作用影响。方法选取2015年2月~2017年2月喀什地区妇幼保健院收治的新疆地区汉族维生素D缺乏症患儿30例作为研究组,另取喀什地区妇幼保健院同期收治的新疆地区维吾尔族维生素D缺乏症患儿25例作为对照组。所有患儿入院后均发放同品牌相同剂型的口服维生素D3治疗,使用剂量为600IU/d。分别采用高效液相-串联质谱仪和高效液相色谱仪并采取液相色谱法和质谱检测法检测两组患儿治疗前、治疗3、6、9、12个月后的血清25-羟维生素D水平。采用双能X线吸收仪检测两组患儿治疗前、治疗3、6、9、12个月后的全身骨矿物密度水平。结果治疗3、6、9、12个月后研究组患儿血清25-羟维生素D水平分别为(50.32±11.52)(61.32±13.59)(78.35±17.95)(92.51±20.12)nmol/L,相比对照组的(43.62±10.88)(49.77±11.47)(63.70±14.45)(80.16±18.22)nmol/L较高(均P<0.05)。治疗3、6、9、12个月后研究组患儿骨矿物密度水平分别为(0.648±0.053)(0.655±0.055)(0.662±0.059)(0.671±0.062),相比对照组的(0.631±0.047)(0.638±0.051)(0.643±0.054)(0.646±0.050)较高(均P<0.05)。结论新疆地区维吾尔族维生素D缺乏症患儿对维生素D的生物利用度相较汉族患儿较低,在临床治疗维吾尔族维生素D缺乏症患儿时,应适当增加维生素D用药剂量,以达到改善患儿预后的目的。

Objective To study the effects of vitamin D dosage on children with vitamin D deficiency in different ethnic groups in Xinjiang.Methods 30 children with vitamin D deficiency of Han nationality in Xinjiang who were admiited and treated in Kashgar Maternal and Child Health Hospital from February 2015 to February 2017 were selected as the study group.25 children with vitamin D deficiency of Uyghur nationality in Xinjiang who were admiited and treated in Kashgar Maternal and Child Health Hospital during the same period were selected as the control group.All patients were treated with oral vitamin D3 in the same dosage form after admission,with a dose of 600 IU/d.High performance liquid chromatography-tandem mass spectrometry and high performance liquid chromatography combined with liquid chromatography and mass spectrometry were used to detect serum 25-hydroxyvitamin D levels of children in the two groups before treatment,after 3 months of treatment,after 6 months of treatment,after 9 months of treatment and after 12 months of treatment.Whole body bone mineral density levels were measured by dual-energy X-ray absorptiometry before treatment,after 3 months of treatment,after 6 months of treatment,after 9 months of treatment,and after 12 months of treatment.Results Serum 25-hydroxyvitamin D levels in the study group were respectively(50.32±11.52)nmol/L,(61.32±13.59)nmol/L,(78.35±17.95)nmol/L and(92.51±20.12)nmol/L after 3 months,6 months,9 months,and 12 months after treatment,higher than(43.62±10.88)nmol/L,(49.77±11.47)nmol/L,(63.70±14.45)nmol/L and(80.16±18.22)nmol/L in the control group(all P<0.05).After 3 months,6 months,9 months,and 12 months after treatment,the bone mineral density levels of the study group were respectively(0.648±0.053)(0.655±0.055)(0.662±0.059)and(0.671±0.062),which was higher than(0.631±0.047)(0.638±0.051)(0.643±0.054)and(0.646±0.050)in the control group(all P<0.05).Conclusion Children with vitamin D deficiency of Uygur nationality in Xinjiang have lower bioavailability of vitamin D than children with Han nationality.In the clinical treatment of children of Uyghur nationality with vitamin D deficiency,the dose of vitamin D should be appropriately increased to improve the prognosis of the children.