我国文献报道维生素D中毒病例诊断依据分析

中国儿童保健杂志 ›› 2011, Vol. 19 ›› Issue (4): 373-376.

我国文献报道维生素D中毒病例诊断依据分析

胡燕琪,盛晓阳

上海交通大学医学院附属新华医院儿童与青少年保健科,上海市环境与儿童健康重点实验室,上海 200092

收稿日期:2010-09-27 发布日期:2011-04-06 出版日期:2011-04-06
通讯作者: 盛晓阳,E-mail:shengxiaoyangcn@yahoo.com.cn
作者简介:胡燕琪(1985-),女,上海人,硕士在读,主要研究方向为婴幼儿营养与健康

Reevaluate of vitamin D intoxication diagnosis of reported cases in recent years in China and the criteria diagnosis and treatment of vitamin D intoxication

HU Yan-qi, SHENG Xiao-yang

Department of Child and Adolescent Health Care, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Children's Environmental Health, Shanghai 200092, China

Received:2010-09-27 Online:2011-04-06 Published:2011-04-06

摘要/Abstract

摘要： 【目的】分析和评估我国近年文献报道的维生素D过量和中毒病例,以期为临床医生正确认识维生素D中毒和预防性补充提供参考。【方法】检索国内主要数据库,收集2004年1月—2010年5月全部维生素D中毒、过量的文献报道,并对报道病例进行分析和总结。【结果】共检索到11篇文献,报道475例维生素D过量或中毒病例。依据目前维生素D过量和中毒诊断标准评估,其中仅23例(4.8%)符合维生素D中毒诊断;17例(3.6%)明确维生素D过量;234例(49.3%)无法肯定诊断;201例(42.3%)缺乏必要诊断依据。【结论】近年来我国确实存在维生素D中毒病例,但部分报道病例诊断依据明显不足。临床医生应警惕维生素D的滥用或误用,同时提高对长期预防性补充维生素D的认识。

关键词: 维生素D, 中毒, 诊断, 治疗

Abstract: 【Objectives】 To reevaluate the diagnosis of vitamin D overdose and intoxication in reported cases in China, to improve the awareness of pediatricians on vitamin D overdose and intoxication, and to properly administrate vitamin D supplements. 【Methods】 All the cases of vitamin D overdose and intoxication reported from January 2004 till May 2010 in major domestic database had been searched by keywords "vitamin D", "overdose", "intoxication". The clinical manifestation, laboratory finding, treatment and prognosis of these cases had been reviewed. 【Results】 A total of 11 references had been searched. There were 475 cases of vitamin D overdose and intoxication had been reported in these references. Among them, 23 cases (4.8%) meet vitamin D intoxication diagnosis criteria; 17 cases (3.6%) were overdose of vitamin D; 234 cases (49.3%) could not be confirmed because incomplete information; 201 cases (42.3%) were misdiagnosis. 【Conclusions】 Almost half of cases are misdiagnosed vitamin D overdose and intoxication. Long-term prophylactic supplement vitamin D is very important to prevent and reduce vitamin D deficiency in children. However, precaution vitamin D abuse or misuse also should be emphasized.

Key words: vitamin D, intoxication, diagnosis, treatment

中图分类号:

R153.2

胡燕琪,盛晓阳. 我国文献报道维生素D中毒病例诊断依据分析[J]. 中国儿童保健杂志, 2011, 19(4): 373-376.

HU Yan-qi, SHENG Xiao-yang. Reevaluate of vitamin D intoxication diagnosis of reported cases in recent years in China and the criteria diagnosis and treatment of vitamin D intoxication[J]. journal1, 2011, 19(4): 373-376.

参考文献

[1] 吴光驰,杨慕兰.我国儿童维生素D中毒与维生素D合理应用[J].中国儿童保健杂志,2004,12(6):512-513.
[2] 瞿平,刘友学,黎海芪.209例儿童维生素D过量分析[J].第三军医大学学报,2004,26(21):1985-1985.
[3] 钟小兰,亢安娜,余灵.婴幼儿维生素D中毒18例[J].人民军医,2004,47(5):285-286.
[4] 刘传玉.同胞双胎婴儿维生素D中毒报告[J].数理医药学杂志,2006,19(2):148-150.
[5] 王保华,戴晓慧.小儿维生素D中毒误诊1例[J].分析中国误诊学杂志,2007,7(6):1271-1271.
[6] 何少为.小儿维生素D中毒三例误诊分析[J].临床误诊误治,2006,19(3):87-88.
[7] 刘向东,刘静杰.小儿维生素D中毒30例临床观察[J].中华现代临床医学杂志,2005,3(23):2533-2536.
[8] 马树志,张贵成.婴幼儿VD₃中毒临床分析[J].黑龙江医药,2007,20(2):177-180.
[9] 张立国,赵军波.小儿维生素D₃中毒187例[J].中国煤炭工业医学杂志,2004,7(5):440-443.
[10] 姚永刚,周勇.口服维生素D₃致中毒1例[J].医学理论与实践,2004,17(4):376-380.
[11] 李琨娥,李俐.维生素AD中毒3例误诊原因分析[J].西南军医,2004,6(6):27-28.
[12] 袁秀琴.维生素D中毒误诊为小儿厌食症5例报告[J].哈尔滨医药,2006,26(3):64-65.
[13] Cranney A, Weiler HA, O'Donnell S, et al. Summary of evidence-based review on vitamin D efficacy and safety in relation to bone health[J].Am J Clin Nutr,2008,88(S): 513-519.
[14] Vieth R. Vitamin D toxicity, policy, and science[J]. J Bone Miner Res,2007,22(S2):64-68.
[15] Glenville J. Pharmacokinetics of vitamin D toxicity[J]. Am J Clin Nutr,2008,88(S): 582-586.
[16] Hathcock JN,Shao A,Vieth R,et al. Risk assessment for vitamin D[J]. Am J Clin Nutr, 2007,85:6-18.
[17] Misra M,Pacaud D,Petryk A,et al.Vitamin D deficiency in children and its management: review of current knowledge and recommendations[J]. Pediatrics,2008,122:398-417.
[18] Ezgu FS,Buyan N,Gunduz M,et al.Vitamin D intoxication and hypercalcaemia in an infant treated with pamidronate infusions[J].Eur J Pediatr,2004,163: 163-165.
[19] Bereket A,Erdogan T.Oral bisphosphonate therapy for vitamin D intoxication of the infant[J].Pediatrics,2003,111:899-901.
[20] Orbak Z,Doneray H,Keskin F,et al.Vitamin D intoxication and therapy with aldendr onate[J]. Eur J Pediatr,2006,165: 583-584.
[21] Wagner CL,Greer FR.Prevention of rickets and vitamin D deficiency in infants, children, and adolescents[J].Pediatrics,2008,122(5): 1142-1152.
[22] 《中华儿科杂志》编辑委员会,中华医学会儿科学分会儿童保健学组,全国佝偻病防治科研协作组.维生素D缺乏性佝偻病防治建议[J].中华儿科杂志,2008,46(3): 190-191.