宝鸡市城区婴幼儿佝偻病患儿的临床特征及血清25(OH)D<sub>3</sub>水平分析

doi:10.3969/j.issn.1671-7171.2023.04.025

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摘要【目的】分析宝鸡市城区婴幼儿佝偻病患儿的临床特征及血清25羟维生素D₃[25(OH)D₃]水平。【方法】选择2020年1月至12月在宝鸡市城区各社区儿童保健门诊进行常规健康管理的274例婴幼儿为研究对象,记录研究对象年龄、性别、身高、体重、饮食情况等基本信息,结合影像学结果分析佝偻病发生情况,比较佝偻病与无佝偻病婴幼儿临床特征及血清25(OH)D₃、骨碱性磷酸酶(BALP)水平,采用受试者工作特征曲线(ROC曲线)分析血清25(OH)D₃、BALP水平预测婴幼儿佝偻病的价值。【结果】年龄≤6个月婴幼儿佝偻病的发病率显著高于其他年龄段的婴幼儿,差异有统计学意义(P=0.016)。佝偻病组多汗、腹泻、骨骼发育异常或迟缓、运动功能障碍、关节疼痛等临床特征发生率高于无佝偻病组,差异有统计学意义(P<0.05)。佝偻病组血清25(OH)D₃水平低于无佝偻病组,血清BALP水平高于无佝偻病组,差异有统计学意义(P<0.05)。ROC曲线分析显示,血清25(OH)D₃、BALP水平预测婴幼儿佝偻病的曲线下面积(AUC)分别为0.958、0.990,特异度分别为0.927、0.976(均P<0.05)。【结论】0~6个月月龄是婴幼儿佝偻病高发的年龄段,临床主要特征为多汗、腹泻、骨骼发育异常或迟缓、运动功能障碍等,且血清25(OH)D₃水平较低,临床应对符合以上因素的患儿进行重点筛查,尽早给予有效的预防及治疗。

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关键词 ：佝偻病/流行病学, 骨化二醇/血液

Abstract：【Objective】 To analyze the clinical characteristics and 25-hydroxyvitamin D₃[25(OH)D₃] levels of infants and young children with rickets in the urban area of Baoji City. 【Methods】 A total of 274 infants and young children who underwent routine health management at children's health clinics in various communities in the urban area of Baoji City from January 2020 to December 2020 were selected as the research objects. Basic information such as age,gender,height,weight,and dietary habits was recorded during the routine physical examination. The prevalence of rickets was analyzed based on imaging results. The clinical characteristics and levels of 25(OH)D₃ and bone alkaline phosphatase (BALP) were compared between infants and young children with and without rickets. The value of 25(OH)D₃ and BALP levels in predicting rickets in infants and young children was evaluated through ROC analysis. 【Results】 The incidence of rickets in infants aged 0 to 6 months was significantly higher than that in other age groups (P<0.05),while there was no significant difference in incidence among other age groups (P>0.05). Clinical characteristics such as increased sweating,diarrhea,abnormal or delayed bone development,motor dysfunction,and joint pain were more common in the rickets group than in the non-rickets group (P<0.05). The 25(OH)D₃ level was lower and the BALP level was higher in the rickets group than in the non-rickets group (P<0.05). The ROC analysis confirmed that the 25(OH)D₃ and BALP levels can be used to predict rickets in infants and young children with AUC values of 0.958 and 0.990,respectively,(both with P<0.05). 【Conclusion】 Infants aged 0 to 6 months are a high-risk age group for rickets,with clinical features mainly including increased sweating,diarrhea,abnormal or delayed bone development,motor dysfunction. In addition,the 25(OH)D₃ level is lower in this group. Clinically,it is recommended to focus on screening children with the above risk factors and provide effective preventive and therapeutic measures as early as possible.

Key words： Rickets/EP Calcifediol/BL

收稿日期: 2023-01-12

中图分类号:

R591.44

基金资助:宝鸡市卫生健康科研项目(编号2021-002)

通讯作者: ** E-mail:tang_xin_0326@163.com

引用本文:

柳文婧, 吕菊红, 李冬梅, 吴宁, 陈银银, 颜靖棠. 宝鸡市城区婴幼儿佝偻病患儿的临床特征及血清25(OH)D₃水平分析[J]. 医学临床研究, 2023, 40(4): 571-574.
LIU Wen-jing, LYU Ju-hong, LI Dong-mei, et al. Investigation and Analysis of Clinical Characteristics and 25(OH)D₃ Levels of Infants and Young Children with Rickets in Urban Area of Baoji City. JOURNAL OF CLINICAL RESEARCH, 2023, 40(4): 571-574.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.04.025 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I4/571

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