Kuizon B D, Salusky I B
Department of Pediatrics, UCLA School of Medicine, Los Angeles, Calif, USA.
Miner Electrolyte Metab. 1998;24(4):290-5. doi: 10.1159/000057384.
Intermittent calcitriol (1,25D) therapy has been used for the management of secondary hyperparathyroidism in children with chronic renal failure; however, the development of adynamic bone has been demonstrated in up to 40% of pediatric patients after 12 months of intermittent 1,25D therapy. To assess its effect on linear growth, we compared growth and biochemical data from 16 prepubertal patients with biopsy-proven secondary hyperparathyroidism during 12 months of intermittent 1,25D therapy and the preceding year of daily 1,25D therapy. While Z-scores for height remained stable during daily therapy, values decreased from -1.8 +/- 0.32 to -2.0 +/- 0.33, p < 0.01, during intermittent 1,25D therapy; the largest reductions were seen in those who developed adynamic bone. Reductions in growth may be due to the direct inhibitory effects of large intermittent doses of calcitriol on chondrocyte activity.
间歇性骨化三醇（1,25D）疗法已用于治疗慢性肾功能衰竭儿童的继发性甲状旁腺功能亢进；然而，在接受间歇性1,25D治疗12个月后，高达40%的儿科患者出现了骨无动力症。为了评估其对线性生长的影响，我们比较了16例青春期前经活检证实为继发性甲状旁腺功能亢进患者在间歇性1,25D治疗的12个月期间以及之前每日1,25D治疗一年期间的生长和生化数据。在每日治疗期间，身高Z评分保持稳定，而在间歇性1,25D治疗期间，该评分从-1.8±0.32降至-2.0±0.33，p<0.01；骨无动力症患者的身高降幅最大。生长减缓可能是由于大剂量间歇性骨化三醇对软骨细胞活性的直接抑制作用。
