摘要
背景 除了某些有明确病因的代谢性疾病导致的全面性发育迟缓(GDD),康复治疗是GDD的主要治疗方式;维生素D通过影响神经营养因子在调节神经细胞的发育和分化方面发挥着重要的神经保护作用;但目前关于补充维生素D对GDD患儿临床疗效的研究开展较少。目的 探讨补充不同剂量的维生素D对GDD患儿康复治疗的临床效果。方法 于2020年9月—2022年6月选取在郑州大学第三附属医院康复医学科首次住院就诊的120例GDD患儿为研究对象,采用随机区组化的方法将其分为常规组(38例)、400 U组(37例)和1 200 U组(35例)。常规组仅进行常规康复治疗;400 U组在常规康复治疗的基础上给予口服400 U/d维生素D;1 200 U组在常规康复训练的基础上给予口服1 200 U/d维生素D。收集3组患儿的性别、就诊年龄等基本资料;于入院时(治疗前)及第3个疗程末(治疗后)行血清25羟维生素D[25(OH)D]水平检测和Gesell发育量表评估[评估适应能力、大运动能力、精细运动能力、语言能力和社交能力5个能区的发育商(DQ)];记录发生在患儿住院期间不良事件的次数,并对上述资料进行分析比较。结果 3组患儿性别、居住地、出生季节、分娩方式、就诊年龄、出生体质量、出生胎龄、主要就诊原因比较,差异均无统计学意义(P>0.05)。治疗前,3组患儿25(OH)D水平、Gesell量表各能区DQ值比较,差异均无统计学意义(P>0.05);治疗后,1 200 U组患儿血25(OH)D水平、Gesell量表大运动能力、精细运动能力、语言能力DQ值高于常规组(P<0.05)。第1、2疗程期间,3组患儿不良事件发生率比较,差异无统计学意义(P>0.05);第3疗程期间,1 200 U组患儿不良事件发生率低于常规组及400 U组(P<0.05)。结论 补充1 200 U维生素D对GDD患儿的康复疗效有益,且能减少康复期间不良事件的发生率。
Background Except for global developmental delay(GDD)caused by certain metabolic diseases with clear causes,rehabilitation treatment is the main treatment for GDD.Vitamin D plays an important neuroprotective role in regulating the development and differentiation of nerve cells by affecting neurotrophic factors;however,there is no study on the clinical effect of vitamin D supplementation on children with GDD.Objective To explore the clinical effects of vitamin D supplementation at different doses on the rehabilitation of children with GDD.Methods A total of 110 children with GDD who were hospitalized for the first time in the Department of Rehabilitation of the Third Affiliated Hospital of Zhengzhou University from September 2020 to June 2022 were selected as the study subjects and divided into the conventional group(n=38),400 U group(n=37)and 1200 U group(n=35)using a randomized block grouping method.The conventional group only received conventional rehabilitation;400 U/d of vitamin D was given orally on the basis of conventional rehabilitation to the 400 U group;1200 U/d of vitamin D was given orally on the basis of conventional rehabilitation to the 1200 U group.Basic data such as sex and age at consultation were collected from the children in the 3 groups;serum 25-hydroxyvitamin D[25(OH)D]level and the score of Gesell scale for developmental quotient(DQ)in 5 functional areas of adaptive ability,gross motor ability,fine motor ability,linguistic competence,and social competence were measured at the time of admission and at the end of 3 courses of rehabilitation.The number of adverse events during the hospitalization of the children and the incidence of adverse events were recorded,and the above data were analyzed and compared.Results The comparison of the 3 groups of children in sex,place of residence,season of birth,mode of delivery,age of consultation,birth body mass,birth gestational age,and main reason for consultation showed no statistically significant difference(P>0.05).Before treatment,there was no statistically significant difference in 25(OH)D level and DQ value of each functional area of Gesell scale among the 3 groups of children(P>0.05).After treatment,children in the 1200 U group had higher blood 25(OH)D levels,Gesell scale DQ values for gross motor ability,fine motor ability,and linguistic competence than those in the conventional group(P<0.05).During the first and second course of rehabilitation,the incidence of adverse events in the 3 groups of children showed no statistically significant difference(P>0.05);in the third course of rehabilitation,the incidence of adverse events in the 1200 U group was significantly lower than that in the conventional group.Conclusion Supplementation with 1200 U of vitamin D is beneficial to the rehabilitation outcome of children with GDD and reduces the incidence of adverse events during rehabilitation.
作者
牛国辉
谢加阳
朱登纳
崔博
赵会玲
王明梅
冯欢欢
张萌萌
李停停
NIU Guohui;XIE Jiayang;ZHU Dengna;CUI Bo;ZHAO Huiling;WANG Mingmei;FENG Huanhuan;ZHANG Mengmeng;LI Tingting(Department of Rehabilitation Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Henan Pediatric Clinical Research Center,Zhengzhou 450052,China;Henan Key Laboratory of Child Brain Injury,Zhengzhou 450052,China;Department of Pediatric Neurology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国全科医学》
CAS
北大核心
2025年第3期346-351,共6页
Chinese General Practice
基金
河南省小儿脑损伤重点实验室开放课题(KFKT2021102)。
