钙缺乏性佝偻病：维生素 D 缺乏症
大部分患有维生素 D 缺乏性佝偻病的儿童对维生素 D 和钙的反应良好，但肌内注射比口服治疗的反应率更高。[4]Nield LS, Mahajan P, Joshi A, et al. Rickets: not a disease of the past. Am Fam Physician. 2006 Aug 15;74(4):619-26.https://www.aafp.org/afp/2006/0815/p619.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/16939184?tool=bestpractice.com
钙缺乏性佝偻病：钙缺乏症
钙补充会在一个月内减轻骨痛，并改善活动度。腕部扩大可在 6 个月内消退，但膝关节畸形可能不会自发消退。[30]Oginni LM, Sharp CA, Badru OS, et al. Radiological and biochemical resolution of nutritional rickets with calcium. Arch Dis Child. 2003 Sep;88(9):812-7.http://www.ncbi.nlm.nih.gov/pubmed/12937108?tool=bestpractice.com
钙缺乏性佝偻病：假性维生素 D 缺乏症
骨化三醇的生理剂量一般能促进骨病完全痊愈，并使生化指标恢复正常。
钙缺乏性佝偻病：维生素 D 抵抗
并非所有患者都对口服治疗有反应，但静脉给予钙剂可能改善代谢和骨骼异常。[31]Malloy PJ, Hochberg Z, Tiosano D, et al. The molecular basis of hereditary 1, 25-dihydroxyvitamin D3 resistant rickets in seven related families. J Clin Invest. 1990 Dec;86(6):2071-9.https://www.jci.org/articles/view/114944/pdfhttp://www.ncbi.nlm.nih.gov/pubmed/2174914?tool=bestpractice.com
低血磷性佝偻病：X 连锁、常染色体显性、常染色体隐性、McCune-Albright 综合征
虽经治疗，但许多患者的生长和骨骼愈合已受损。在婴儿早期开始治疗的结局较好，但骨骼发育仍会异常，并且早期生长缺陷可能是永久性的。[32]Mäkitie O, Doria A, Kooh SW, et al. Early treatment improves growth and biochemical and radiographic outcome in X-linked hypophosphatemic rickets. J Clin Endocrinol Metab. 2003 Aug;88(8):3591-7.https://academic.oup.com/jcem/article/88/8/3591/2845268http://www.ncbi.nlm.nih.gov/pubmed/12915641?tool=bestpractice.com[33]de Menezes Filho H, de Castro LC, Damiani D. Hypophosphatemic rickets and osteomalacia. Arg Bras Endocrinol Metabol. 2006 Aug;50(4):802-13.http://www.ncbi.nlm.nih.gov/pubmed/17117305?tool=bestpractice.com
伴高钙尿症的遗传性低血磷性佝偻病
患者可能对治疗有反应。有报道指出，肾脏磷酸盐消耗缺陷在生命较后期自发性改善。[34]Econs MJ, McEnery PT. Autosomal dominant hypophosphatemic rickets/osteomalacia: clinical characterization of a novel renal phosphate-wasting disorder. J Clin Endocrinol Metab. 1997 Feb;82(2):674-81.https://academic.oup.com/jcem/article/82/2/674/2823552http://www.ncbi.nlm.nih.gov/pubmed/9024275?tool=bestpractice.com
低血磷性佝偻病：肿瘤诱发性
手术移除肿瘤可治愈佝偻病，但并非所有儿童均能完全缓解。[33]de Menezes Filho H, de Castro LC, Damiani D. Hypophosphatemic rickets and osteomalacia. Arg Bras Endocrinol Metabol. 2006 Aug;50(4):802-13.http://www.ncbi.nlm.nih.gov/pubmed/17117305?tool=bestpractice.com
畸形的管理
未经任何治疗的佝偻病会引起骨骼永久畸形，并导致身材矮小。可能需要外科干涉，以修复严重的骨骼畸形。[4]Nield LS, Mahajan P, Joshi A, et al. Rickets: not a disease of the past. Am Fam Physician. 2006 Aug 15;74(4):619-26.https://www.aafp.org/afp/2006/0815/p619.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/16939184?tool=bestpractice.com
