Meta-analysis of the efficacy of combined therapy vitamin D with calcium in nutritional rickets / 国际儿科学杂志

ABSTRACT

Objective To assess the efficacy of combined vitamin D with calcium and vitamin D or cal-cium alone in rickets of vitamin D deficiency by meta-analysis method. Methods Searches were made in Cochrance Library , Pubmed, Web of science, Scirus, CNKI, Chinese Biological Medical Literature Database, (CBM),Wangfang from the establishment of the data base till March 2013. All randomized controlled trials about combined with vitamin D and calcium in rickets of vitamin D deficiency were eligible. Serum 25-( OH) ritamin D,phosphate ,ALP,calcium,PTH,phosphate,albumin ,radiographic score were chosen as evaluation in-dex to evaluate the weighted mean diffreence ( WMD) and 95% confidence interval ( CI) for continuous data. RevMan 5. 0. 2 software was used to make meta-analysis. Results 437 literatures were reviewed. Three eligible trials were used for meta-analysis. Meta-analysis showed that(1)the increase of Serum 25-(OH)vitamin DCombined therapy group and vitamin D group (MD= -7. 88,95%CI-12. 24~ -3. 52);Combined therapy group and calcium group (MD= -18. 32,95%CI-22. 61~ -14. 04). (2)the increase of serum phosphateCombined therapy group and vitamin D group ( MD= -0. 64 ( 95%CI-0. 86 ~ -0. 42 );Combined therapy group and calcium group MD= -0. 16 ( 95%CI-0. 84 ~0. 51 ) . ( 3 ) the decrease of Serum ALPCombined therapy group and vitamin D group (MD= 109. 99,95%CI20. 40 ~199. 58);Combined therapy group and calcium group (MD=59. 89,95%CI10. 09~109. 59 ). (4)the increase of serum calciumCombined therapy group and vitamin D group (MD= -0. 71,95%CI-0. 91,-0. 52);the decrease of Radiographic scoreCom-bined therapy group and vitamin D group( MD=0. 68,95%CI0. 42~ 0. 95). Except that the increase of serum phosphate between combined therapy group and calcium group had no significant difference,the rest had signifi-cant difference. Conclusion The long term efficacy in combined therapy group is much effective than vitamin D group or calcium group.