口服1α-羟基维生素D3治疗肥胖症空肠回肠旁路术后的骨病
Treatment of bone disease after jejunoileal bypass for obesity with oral 1 alpha-hydroxyvitamin D3.
作者信息
Compston J E, Horton L W, Laker M F, Merrett A L, Woodhead J S, Gazet J C, Pilkington T R
出版信息
Gut. 1980 Aug;21(8):669-74. doi: 10.1136/gut.21.8.669.
The effects of oral 1 alpha-hydroxyvitamin D3 have been investigated in 12 patients with bone disease after jejunoileal bypass for obesity. Bone histology became normal or improved greatly after four to 12 months' treatment in eight patients but showed little change or worsened in four. There was a significant rise in plasma calcium and fall in plasma alkaline phosphatase concentration with 1 alpha-hydroxyvitamin D3 therapy in the patients with a good histological response. Administration of metronidazole and cotrimoxazole to two patients who had failed to respond to 1 alpha-hydroxyvitamin D3 resulted in clinical and biochemical improvement; in one of these patients histological improvement was also documented. It is concluded that oral 1 alpha-hydroxyvitamin D3 can be effective in healing post-bypass bone disease; the failure of some patients to respond may be related to bacterial contamination of the small intestine and in those patients antibiotics may also be indicated.
对12例因肥胖行空肠回肠旁路术后患骨病的患者，研究了口服1α-羟基维生素D3的效果。8例患者经4至12个月治疗后，骨组织学恢复正常或明显改善，但4例变化不大或病情恶化。组织学反应良好的患者接受1α-羟基维生素D3治疗后，血浆钙显著升高，血浆碱性磷酸酶浓度降低。对2例对1α-羟基维生素D3无反应的患者给予甲硝唑和复方新诺明后，临床和生化指标均有改善；其中1例患者骨组织学也有改善。结论是口服1α-羟基维生素D3对治愈旁路术后骨病可能有效；部分患者无反应可能与小肠细菌污染有关，对这些患者也可能需要使用抗生素。
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