de Jonge H J M Henk-Marijn, Gans R O B Rijk, Huls Gerwin
Universitair Medisch Centrum Groningen, Afd. Interne Geneeskunde, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(34):A4343.
Various calcium supplements are available for patients who have an indication for calcium suppletion. American guidelines and UpToDate recommend prescribing calcium citrate to patients who use antacids The rationale for this advice is that water-insoluble calcium carbonate needs acid for adequate absorption. No convincing scientific evidence supporting the advice to prescribe calcium citrate instead of calcium carbonate to patients who also take antacids is available, and therefore deserves further investigation. On the contrary, the fact that calcium carbonate does not need acid in order to be absorbed, has also not been proven. In clinical practise, it appears important that calcium is taken with meals in order to improve its absorption.
对于有补钙指征的患者,有多种钙补充剂可供选择。美国指南和UpToDate建议给使用抗酸剂的患者开具柠檬酸钙。给出该建议的理由是水不溶性碳酸钙需要胃酸才能充分吸收。然而,对于同时服用抗酸剂的患者,没有令人信服的科学证据支持用柠檬酸钙替代碳酸钙的建议,因此值得进一步研究。相反,碳酸钙不需要胃酸就能吸收这一说法也尚未得到证实。在临床实践中,随餐服用钙似乎对提高其吸收率很重要。