骨碱性磷酸酶在早期诊断佝偻病中的临床意义

为探讨骨碱性磷酸酶（BALP）在早期诊断佝偻病中的临床意义,于1995年2月－1997年2月对50例VD缺乏性佝偻病患儿进行了BALP检测,并与传统法血钙、磷、碱性磷酸酶检测进行了比较,结果表明佝偻病组BALP值明显升高。与正常对照组有高度显著性差异,BALP阳性检出率与其他血Ca、P、AKP阳性检出率对照也有高度显著性差异,提示血BALP测定是一种简便、快速、特异、早期诊断佝偻病的好方法。     

骨碱性磷酸酶对早期佝偻病的诊断及临床研究

目的 探讨骨碱性磷酸酶（BALP）在基层医院早期佝偻病诊断中的临床意义；方法 对89例VitD缺乏性佝偻病患儿进行BALP检测并设立正常对照组，对BALP≥250u/L者，结合临床表现进行左腕部X线片检查，并对确诊为佝偻病的患儿给予VitD3等药物治疗，并用BALP动态监测，观察临床疗效；结果 发现血BALP检测具有简便易行，快速安全，敏感特异等优点。结论 BALP检测是目前基层医院快速诊断早期佝偻病的好方法。亦是早期评价佝偻病疗效的主要指标之一。     

检测骨碱性磷酸酶筛查新生儿先天性佝偻病的结果分析

目的了解先天性佝偻病发病情况及其影响因素,探讨检测骨碱性磷酸酶（BALP）筛查方法的效果。方法 2009年～2010年,在大庆市1000名出生1周内的新生儿进行骨碱性磷酸酶（BALP）和血清钙、磷、碱性磷酸酶（ALP）检测,以筛查先天性佝偻病。结果检测1000名新生儿,先天性佝偻病阳性率BALP检测为12.60%,血清生化检测为1.60%（P〈0.01）。检测1岁以下婴儿200名,BALP与血清生化检测阳性率均为28.50%。BALP检测阳性率胎龄〈34周者最高,出生体重〈2 000 g者最高,第1季度出生者最高（P〈0.01或〈0.05）。结论用检测BALP筛查先天性佝偻病比检测血清钙、磷、ALP敏感。     

孕妇血清中钙、磷、碱性磷酸酶与全血骨碱性磷酸酶检测结果分析

目的通过检测孕妇血清中钙（Ca）、磷（P）、碱性磷酸酶（ALP）、全血骨碱性磷酸酶（BALP）,早期预防婴幼儿佝偻病的发生。方法对2005年12月－2007年10月来我院就诊的孕早、中、晚期的孕妇采血进行Ca、P、ALP、BALP的测定。结果与结论孕妇血清中Ca、P、ALP、BALP血清水平在不同孕期存在差异。     

宁波地区390例小儿骨源性碱性磷酸酶检测结果及临床分析

目的检测小儿血中骨源性碱性磷酸酶（BAP）活性,用以筛查或辅助诊断因钙营养不良引起的骨钙化障碍或其他原因引起的代谢性骨病。分析年龄、性别、喂养方式对小儿BAP活性的影响,从而为防治儿童营养性佝偻病提供参考。方法采用北京中生金域诊断技术有限公司提供的小儿骨源性碱性磷酸酶（NBAP）试剂盒,采末梢血进行测定。并比较年龄、性别、喂养方式对小儿BAP活性的影响。结果 390例中BALP〈200U/L者102例,占26.2%;200～250 U/L者148例,占37.9%;〉250 U/L者140例,占35.9%。年龄越小,临界水平和阳性百分率越高。但阳性率随着年龄的增长具有明显的下降趋势。3月～一组与2岁～一组BALP检测结果比较统计学上无差异（P〉0.05）;2岁～一组与4～5岁一组BALP检测结果比较统计学上有显著性差异（P〈0.05）;3月～组与4～5岁一组BALP检测结果比较统计学上差异显著（P〈0.001）。母乳、人工、混合3种不同喂养方式统计学上比较BALP有显著性差异（χ2=22.74,P〈0.01）。结论年龄、喂养方式对婴幼儿BAP活性有影响。小儿BAP检测可作为早期发现、早期诊治小儿骨钙化障碍或代谢性疾病的灵敏指标。     

自制血清快速分离板在儿童碱性磷酸酶检测中的应用

目的用研制成功的血清快速分离板检测儿童碱性磷酸酶（ALP）,评价其应用价值。方法选取天津市儿童医院门诊体检儿童和住院佝偻病患儿共200例,年龄1个月-7岁,其中男性138例,女性62例;从每例受试者手指分别取30μl末梢血同时用血清快速分离板和市售的骨源性碱性磷酸酶（BALP）试剂盒检测,进行结果比对。结果用血清快速分离板检测ALP,显示结果准确度、重复性良好,显色稳定;200例样本经两种方法比对,结果差异无统计学意义（P〉0．05）。结论利用自行研制的血清快速分离板检测儿童ALP,操作简便,试剂稳定,结果易于判别且成本低廉,有利于儿童佝偻病和钙缺乏的诊断和治疗。     

小儿先天性佝偻病早期防治研究

目的 为观察孕后期一次肌注维生素D330万U和口服钙剂来防治先天性佝偻病的效果，用全血干化学免疫浓缩法对567例正常新生儿进行骨碱性磷酸酶（BALP）活性测定。本研究严格依据国家关于先天性佝偻病的诊断标准。方法 在妇产科从东营地区各单位和周围自然村选出孕期满7－9个月的孕妇570名，随机分成预防组和对照组，预防组于孕期7、8或9个月肌肉注射VitD330万U，口服葡萄糖酸钙：每天3g，直至分娩为止。对照组不给任何药物。对两组孕妇生后3天之内正常新生儿567名进行骨碱性磷酸酶检测。采用χ^2与t检验分析先天性佝偻病早期预防的必要性。结果 预防组孕妇285例，有腓肠肌痉挛史者108例，经VitD3和钙剂治疗后仅11例出现腓肠肌痉挛，发生率为3.9%。正常分娩新生儿283例，男145名，女138名，骨碱性磷酸酶检测BALP大于200U／L者47名，异常检出率16.6%。X线检查结果异常35例，异常检出率为12.3%。对照组孕妇285名，有腓肠肌痉挛史者103例，未经任何药物治疗有85例出现腓肠肌痉挛，发生率为29.8%。正常分娩新生儿284例，男139例，女145例，BALP大于200U／L者141例，异常检出率为49.6%。X线结果异常76例，异常检出率为26.8%。结论 经调查表明孕末期投用VitD3和钙剂，孕妇腓肠肌痉挛发生率由29.8%下降到3.9%；小儿先天性佝偻病用骨碱性磷酸检测法，异常检出率由49.6%下降到16.6%，用X线摄片检查法，异常检出率由26.8%下降到12.3%，P值均＜0.01，说明防治效果满意。     

骨碱性磷酸酶测定在诊断小儿佝偻病中的应用

佝偻病,又称维生素D缺乏性佝偻病,是我国小儿四大防治疾病之一.佝偻病不仅使小儿骨发育迟缓、骨质软化,还能引起肌肉、免疫等组织器官功能异常,易患上感染性疾病,严重影响儿童的健康.因此,佝偻病的早期诊断,具有重大意义.现将我们利用骨碱性磷酸酶(BALP)检测法和血生化检测法对海口地区婴幼儿佝偻病的监测情况,总结分析如下.     

农村儿童佝偻病防治的若干体会

目的 探讨多因素、多途径对维生素D缺乏性佝偻病防治的影响.方法根据佝偻病的诊断标准、家长对防治佝偻病的知晓程度判断多因素影响佝偻病形成,骨碱性磷酸酶检测对佝偻病防治有指导价值.结果通过各方面因素有无的对比、母亲的文化程度影响佝偻病的数量,早期利用骨碱性磷酸酶检测作为临床指导用药及宣教.结论 因多种因素影响佝偻病的形成,母亲孕期和婴儿从出生后都要有干预,对防治效果更理想.     

骨骼畸形儿童的临床研究

目的探讨骨骼畸形与晚发性佝偻病(DR)的关系.方法采用病例对照,结合临床调查,检测了85例骨骼畸形儿童及50例健康儿童的血钙、血磷、碱性磷酸酶(ALP)、骨碱性磷酸酶(BALP)、X线.结果 85例5～16岁骨骼畸形儿童的临床症状主要为多汗、肢体疼痛、肢体无力、肌肉痉挛;体征以鸡胸和X形腿为多见;血钙、血磷、碱性磷酸酶检测阳性率均低,BALP测定阳性率(BALP>250U/L)为14.1%,诊断为DR,并与对照组比较,差异有显著性意义(p<0.05).结论要重视骨骼畸形儿童的诊断及DR的诊断和防治工作.     

骨骼畸形儿童的临床研究

目的探讨骨骼畸形与晚发性佝偻病(DR)的关系.方法采用病例对照,结合临床调查,检测了85例骨骼畸形儿童及50例健康儿童的血钙、血磷、碱性磷酸酶(ALP)、骨碱性磷酸酶(BALP)、X线.结果85例5～16岁骨骼畸形儿童的临床症状主要为多汗、肢体疼痛、肢体无力、肌肉痉挛;体征以鸡胸和X形腿为多见;血钙、血磷、碱性磷酸酶检测阳性率均低,BALP测定阳性率(BALP>250U/L)为14.1%,诊断为DR,并与对照组比较,差异有显著性意义(p<0.05).结论要重视骨骼畸形儿童的诊断及DR的诊断和防治工作.     

Leukocyte function as one of the indices of resistance to influenza in children

Preliminary results of comparative characterization of the functional activity of leukocytes by cytochemical, virologic, immunologic, and clinical methods of examinations in institutionalized young infants are summarized. The observations covered 100 infants varying in ages from 1 to 3 years with frequent and rare incidence of respiratory diseases. The diagnosis of influenza had been confirmed by serological methods: CFT and ELISA. Infants with positive serodiagnosis were selected for further studies. The functional status of leukocytes was determined by the interferon leukocyte test (ILT), alkaline phosphatase and myeloperoxidase activities. The results presented in the Tables have shown the infants frequently suffering from ARVD to have low values of ILT and higher values of alkaline phosphatase activity but low myeloperoxidase activity. More resistant infants with rare incidence of ARVD had high ILT, high myeloperoxidase activity and low alkaline activity. It is suggested that alkaline activity of leukocytes alone may be of informative value.     

Identification of bone and liver metastases from breast cancer by measurement of plasma alkaline phosphatase isoenzyme activity.

Plasma alkaline phosphatase isoenzyme activities were determined in patients with breast cancer to diagnose and monitor bone and liver metastases. Bone alkaline phosphatase activity was increased in 21 of 50 patients (42%) with radiologically confirmed bone metastases, while total alkaline phosphatase activity was increased in only 10 of 50 (20%); liver alkaline phosphatase activity was raised in 12 of 25 patients (48%) with liver metastases. All patients with liver metastases had bone metastases. Bone alkaline phosphatase activity was significantly higher in patients with symptomatic bone disease. Isoenzyme determination provided additional information that would have changed patient management in five of 20 patients who were monitored serially. Measurement of alkaline phosphatase isoenzyme activity, though less sensitive than imaging procedures, can assist in screening for, and in early detection of, a high proportion of bone and liver metastases, and can provide useful objective evidence of their response to treatment.     

Effect of physical activity on bone turnover in young boys

AIMS: To evaluate the effect of the physical activity on bone turnover in young male soccer players at the Tanner's stage of 1-2. MATERIAL AND METHODS: 61 young soccer players (13,4 +/- 0,3 years old) who actively participated in soccer since 3,7 +/- 0,7 years were compared to 60 age and sex- matched non active subjects. Bone mineral density (BMD) of whole body, and in specific skeleton sites, fatty body mass (FBM) and lean body mass (LBM) were determined by a dual energy X-ray absorptiometry (DXA). Total plasma alkaline phosphatase (ALP) and plasma bone alkaline phosphatase (BALP), plasma osteocalcin (OC) and plasma collagen type I cross-linked C-telopeptide (CTX) were measured. RESULTS: BMD of the whole body and at the lumbar spine (L2-L4), femoral, lower limbs and LBM were significantly higher in young soccer players than in controls. The biochemical markers of bone turnover: ALP (6,7%), BALP (8,9%), OC (3%) and CTX (3,1%) were not significantly higher in sportsmen than in controls. The calcium was significantly higher in sportsmen than in controls. CONCLUSION: These results suggest that soccer practice induced an increase of bone mass in boys. The increase in the level of bone turnover evaluated by the new biochemical markers was not significant in the sportsmen.     

Biochemical observations in Blount's disease (infantile tibia vara)

Blount's disease or congenital tibia vara is a clinical entity characterized by tibia bowing, tibia torsion, and beaking of the medial tibia metaphysis on plain radiograph. In our environment, burnt-out rickets patients with biochemical and radiological diagnosis of rickets who after treatment still have residual bone changes despite normal bone biochemistry) can also present with similar clinical and radiological features as Blount's disease. However, certain biochemical variations, including antioxidants, may serve as a basis for differentiation between these two disorders. The serum levels of calcium, inorganic phosphate, zinc, copper, and alkaline phosphatase in 15 patients (10 females and five males) aged between two- and five years (mean 3.8 +/- 1.1 (SD)) with clinical and radiological features of Blount's disease were determined. The mean weight of the patients with Blount's disease was 14.0 +/- 2.4 kg (range: 11.5-16.3 kg). Fifteen subjects (nine females and six males) matched for age and sex without clinical features of any metabolic bone and/or nutritional diseases who were attending the surgical outpatient clinic served as control subjects. The serum concentrations of inorganic phosphate and calcium, though lower in patients with Blount's disease compared with controls, did not reach statistical significance. Alkaline phosphatase activity was increased in the serum of all patients with Blount's disease. In addition, there was an observed significant reduction in serum concentration of zinc (P < 0.03) compared to the control subjects. As for calcium level, the concentration of serum copper in Blount's patients was reduced, but this was not statistically significant. These biochemical observations, especially those of the antioxidant micronuent zinc, may serve as a basis for the differentiaion of the sometimes clinically inseparable disorders of Blount's and rckets and may aid in early differential diagnosis, appropriate treatment as well as prevention of complications.     

共转录因子CITED1在小鼠骨代谢中的调控作用

目的在体研究CITED1在骨代谢即成骨/破骨平衡中的调节作用,为骨质疏松的治疗提供相应的理论基础。方法利用野生型小鼠(WT小鼠)和构建的CITED1基因敲除小鼠(KO小鼠),显微电子计算机断层扫描(CT)定量测量WT小鼠和KO小鼠股骨长度、骨量和骨皮质以及骨松质厚度等骨骼表型。用ELISA检测骨代谢的血液学相关指标。用RT-qPCR检测骨标志基因的表达,从分子水平探究骨代谢改变的原因。结果 KO小鼠颅骨成骨细胞中CITED1表达极少,表明敲除成功。KO小鼠股骨长度、骨量和骨皮质以及骨松质厚度显著高于WT小鼠。KO小鼠外周血血清中I型原胶原肽(P1NP)、骨钙素(OC)和骨碱性磷酸酶(BALP)浓度均显著高于WT小鼠,而抗酒石酸酸性磷酸酶(TRAP)的浓度显著低于WT小鼠。RT-qPCR结果显示,KO小鼠颅骨成骨细胞中OC和BALP基因表达较WT小鼠显著增加(P<0. 001);同时,KO小鼠颅骨成骨细胞中抗酒石酸酸性磷酸酶(TRAP)的表达较WT小鼠显著降低(P<0. 05)。结论小鼠CITED1敲除后可以通过上调OC和BALP基因表达,下调TRAP基因的表达,促进骨形成,抑制骨吸收。     

去势大鼠5种骨转换生化指标的动态变化

目的： 对去势大鼠骨质疏松动物模型形成过程中5种骨转换指标的变化及其相关性进行研究。方法: 将3月龄SD雌性大鼠分为3组：切除卵巢组(OVX)，假手术组(sham)和对照组(control)，术前和术后分别于1、1.5、2、2.5、3和4月检测血清骨钙素(OC)、碱性磷酸酶(ALP)、 骨碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶(TRAP)和羟脯氨酸(HYP)水平，并作大鼠胫骨病理切片检查。结果: OVX组血清OC、ALP、BALP、TRAP和HYP水平均明显高于sham组，其变化顺序依次为：TRAP/HYP→OC→ALP/BALP；5种指标之间呈显著正相关；术后3月OVX组大鼠胫骨小梁结构有病理改变。结论: 去势大鼠属于高转换型骨质疏松；在模型形成过程中，骨吸收指标的变化早于骨形成指标的改变；骨转换指标是反映绝经后早期骨量丢失的灵敏指标。