Treatment Protocol for Vitamin D：维生素D的治疗方案.doc

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1、AdultVitaminDguidelinesTheChiefMedicalOfficersoftheUKgaveadviceinFebruary2012toGPs,practicenurses,healthvisitorsandcommunitypharmacistsaboutsupplementationwithvitaminDtothoseathighrisk.Principalrecommendationsofthiscommunicationincludedsupplementationwith400

2、unitsofvitaminDdailytothoseovertheageof65years,andtopeoplewhoarenotexposedtomuchsun.Nomentionofpriorinvestigationorsubsequentmonitoringwasmade.ThiscurrentguidelineshouldbeusedwheretheGeneralPractitioner(orothermedicalstaffdeterminingmanagement)feelsapatients

3、clinicalfeatureswarrantpriorassessmentrelatingtotheirVitaminDstatusorareotherwisenotsatisfiedthatitisstraightforwardinapatientscasetoapplytheaboveadvice(forpotentiallylongtermVitaminDtreatment)withoutinvestigationormonitoringlestitbeunsafeorinadequate.Somere

4、asonsforthismayinclude:•ThepatientcomplainsofsymptomsrequiringdiagnosisandpotentiallyhighdosetreatmentwithvitaminDwheredeficiencyexists•ThepatientmaybeatriskofcomplicationsfromtreatmentwithvitaminDduetoahypercalcaemicdisorder,previousrenalstones,renalimpairm

5、ent,granulomatousdisorderetc•ThepatientmaybeunwillingtotakelongtermsupplementswithoutdefiniteevidenceofpoorvitaminDstatus.Thecurrentguidelineisdesignedforuseinsymptomaticadultsand/orthosewithabnormalbiochemistryrequiringinvestigation,diagnosisandtreatment.Th

6、eguidelinealsoaimstohighlightthosewithmedicalconditionswhichmayputthematriskofvitaminDdeficiency,orcausetreatmentwithvitaminDtobecomplexorpotentiallyrisky.Paediatricsubjectsshouldbediscussedwiththepaediatricteam,whohavedevelopedasetofpaediatricguidelinesforu

7、seinsecondarycare.GroupsatRiskofVItDdeficiency(s3.1)•Diet♦Reducedsunlightexposure•Darkskin•Malabsorption•Conditionrequiringspecialistadvice?(s3.1)TreatmentProtocolforVitaminDPleaseseefullreferralguidelinesinmainbodyoftextand/ordiscusswithendocrineregistraron

8、-callifuncertainSuspectedVitaminDdeficiencybecause:-•“-•“i••“—•••RiskFactors(sees3.1)ORSuggestivesymptoms(mostcommonlyBonepain,bonetenderness,muscleweakness)Considerspecialistadviceorreferral(s3