新生儿骨碱性磷酸酶活性与母亲妊娠相关因素研究

目的：了解新生儿先天性佝偻病的发病率及与母亲妊娠的相关因素。方法：用全血干化学免疫浓缩法对615例新生儿进行了骨碱性磷酸酶(BALP)活性测定,采用多元线性及逐步回归法分析新生儿BALP活性水平与母亲妊娠影响因素的相关性。结果：受检615人,BALP≤200U/L 430例,～250U/L 82例,～300 U/L 103例,异常检出率30.08%。BALP活性增高程度与新生儿早产、易惊、多汗、睡眠不安、颅骨软化、鸡胸、漏斗胸、肋骨串珠有明显相关性(P0.05)。结论：先天性佝偻病的发病率较高,预防先天性佝偻病应从围生期做起;对生后有佝偻病症状者及早产儿,应及时检测BALP水平,以便早期诊断,早期治疗。     

兰州地区585例新生儿骨碱性磷酸酶测定及相关因素分析

为了解兰州地区新生儿佝偻病的发病率及其相关因素,用全血干化学免疫浓缩法对５８５例新生儿进行了骨碱性磷酸酶活性测定。统计采用多元线性回归及逐步回归分析法。结果：ＢＡＬＰ≤２００Ｕ／Ｌ３７０例,￣２５０Ｕ／Ｌ１６７例,￣３００Ｕ／Ｌ４８例,异常检出率为３６．７５％。早产儿、低体重儿易惊、囟门大者,ＢＡＬＰ活性增高。母孕期日晒少、饮食中缺乏维生素Ｄ、贫血、下肢抽搐或疼痛者易使新生儿ＢＡＬＰ活性增高。提示     

新生儿血铅水平和产妇因素的相关性

为了探讨新生儿血铅水平与产妇相关因素的关系 ,我们对 30 9例新生儿及产妇进行了血铅含量测定 ,现报告如下。临床资料一、一般资料　对 1999年 9月～ 11月我院产科出生的新生儿进行了耳垂外周微量血血铅水平测定。采用随机抽样的方法 ,每周二、五上午对刚出生婴儿采血 1次 ,共取样30 9例 ,同时测产妇的血铅含量。产妇来自新乡市的市区和乡村。 30 9例中男 180例 ,女 12 9例。胎龄 34 .0～ 42 .2周 ,平均 (39.6± 1.5 )周 ;出生体重 2 2 0 0～ 46 0 0ｇ ,平均 (330 0±410 )ｇ。剖宫产 90例 ,余为顺产。日龄均≤ 4ｄ。产妇年龄 2 3～ 41ａ ,…     

骨碱性磷酸酶在佝偻病早期诊疗中的应用

目的探讨骨碱性磷酸酶(BALP)在佝偻病早期诊断中的作用。方法采用日立7170型自动生化分析仪对诊断为佝偻病的患儿进行血清BALP、钙、磷的测定,同时进行外型特征等资料分析。结果患儿BALP异常率92.4%(61/66),钙的异常率为21.2%(14/66),磷的异常率28.8%(18/66),碱性磷酸酶异常率53.0%(35/66)。结论血清BALP的测定对佝偻病早期诊断特异性强,方法简单,有利于佝偻病的早期诊断,早期发现、早期治疗和指导早期治疗。     

活动期佝偻病治疗前后骨碱性磷酸酶及骨X线变化相关性探讨

佝偻病是婴幼儿常见病及多发病,在２５（ＯＨ）Ｄ３和１,２５－（ＯＨ）２Ｄ３测定不能在基层医院普遍开展的情况下,骨碱性磷酸酶（ＢＡＬＰ）测定仍为诊断佝偻病较特异、敏感指标,也可作为佝偻病疗效判断的重要指标［１］。为了解维生素Ｄ缺乏性佝偻病治疗前后ＢＡＬ...     

新生儿佝偻病与孕期保健

目的 采用骨硷性磷酸酶（ＢＡＬＰ）活性测定以早期诊断先天性佝偻病,了解兰州先天性佝偻病的发病状况及评价妊娠母亲与此病的相关因素。方法 使用ＢＡＬＰ试剂盒,用全血干化学免疫浓缩法对兰州市５８５例新生儿,ＢＡＬＰ活性测定。结果 ＢＡＬＰ≤２００Ｕ／Ｌ３７０例,～２５０Ｕ／Ｌ１６７例,～３００Ｕ／Ｌ４８例,异常率为３６．７５％;对ＢＡＬＰ活性〉２００Ｕ／Ｌ以上的２１５例测血钙、磷降低者分别是１９０例和２     

骨碱性磷酸酶诊断学龄前期儿童亚临床型佝偻病

骨碱性磷酸酶诊断学龄前期儿童亚临床型佝偻病（解放军第３２２医院儿科０３７００６）贺树清，马福云，孙书业，林秀英，解放军第３２２医院检验科，刘佃满笔者应用中国医学科学院研制的全血干化学免疫浓缩骨碱性磷酸酶（ＢＡＬＰ）试剂盒，对我院幼儿园学龄前期儿童进行...     

骨碱性磷酸酶测定在佝偻病诊断中的应用

应用骨碱性磷酸酶(BALP)试条对106例有佝倭病临床表现及52例正常对照儿童进行BAIP活性测定.其异常检出率分别为90.6％和13.5％.两者对比有非常显著性差异(P<0.005);106例佝偻病患儿同时检测血清钙、磷、碱性磷酸酶及右腕关节x线掇片,异常检出率分别为45.3％、44.3%、47.2％及37.7％。均非常明显低于BALP异常检出率(P<0.01);30例佝偻病患儿经维生素D治疗后复查BALP,90%降 至正常范围。提示BALP试纸方法具有灵敏、准确、简便,可用于佝倭病早期诊断及临床疗效的观察。     

新生儿骨碱性磷酸酶测定与先天性佝偻病筛查的相关性分析

目的探讨骨碱性磷酸酶(BALP)筛查先天性佝偻病的价值，了解先天性佝偻病相关发病因素。方法(1)测定450例早期新生儿BALP的活性，同时做血清钙(Ca)、磷(P)、碱性磷酸酶(ALP)测定对比。(2)同时采用上述两种监测方法筛查1岁以内佝偻病检出率作对比。结果(1)新生儿组BALP阳性检出率14％，明显高于血清Ca、P和ALP阳性率1．8％。(2)1岁以内组两种方法检出率相同均为28％。(3)发病因素与胎龄、出生时体重、出生的月份密切相关。结论(1)BALP的测定是筛查先天性佝偻病的优选方法，对早期诊断、早期干预有重要价值。(2)发病因素与孕周、体重、出生的月份关系密切：     

妊娠期低水平铅暴露对新生儿血清钙、骨钙素及骨碱性磷酸酶的影响

目的研究妊娠期低水平铅暴露对新生儿血清钙(Ca)、骨钙素(OC)及骨碱性磷酸酶(BALP)的影响。方法于新生儿娩出断脐后采集脐静脉血5 ml分别检测血铅、血清钙、血清骨钙素及骨碱性磷酸酶,将新生儿以血铅值50μg/L、100μg/L为界分为低铅组(<50μg/L)、相对高铅组(50～99μg/L)和高铅组(≥100μg/L),研究脐血铅对新生儿骨代谢相关指标的影响。结果新生儿脐血铅水平与其血清骨钙素、血清钙水平呈负相关,与骨碱性磷酸酶水平呈正相关。高铅组与低铅组比较,血清骨钙素水平、血清钙几何均数水平显著降低;高铅组碱性磷酸酶水平显著高于相对高铅组及低铅组。结论妊娠期低水平铅暴露可能干扰了新生儿骨代谢。     

Serial measurements of serum alkaline phosphatase for early prediction of osteopaenia in preterm infants

Aim: Osteopaenia commonly occurs in preterm infants; however, its diagnosis is often delayed when based on radiological findings. The aim of this study was to examine whether serial measurements of bone turnover markers are useful for early prediction of osteopaenia in preterm infants. Methods: Premature infants of ≤34 weeks gestation were enrolled. Serum alkaline phosphatase (ALP), bone form ALP (BALP), calcium and inorganic phosphate were concurrently measured biweekly from 3 weeks post‐natal age until 40 weeks post‐conceptional age. Radiographic examination of the forearm was performed at term age. Osteopaenia was defined as positive radiographic findings according to Koo's criteria. Results: Of the 46 premature infants completing the follow‐up study at term age, 18 showed osteopaenia in radiographic examination. Serum ALP was highly correlated with BALP (R² = 0.93, P < 0.001). Infants who had osteopaenia showed a higher level of ALP and BALP after 3 weeks post‐natal age than those who had no osteopaenia. ALP concentration exceeding 700 IU/L at 3 weeks post‐natal age was predictive of osteopaenia at term age (sensitivity 73% and specificity 73%) and so did for the predictive value of BALP concentration exceeding 95 ug/L (sensitivity 73% and specificity 80%). BALP measures provided no greater benefit of diagnostic performance than ALP in early detection of osteopaenia. Furthermore, premature infants with osteopaenia showed similar levels of calcium and inorganic phosphatase concentration compared with those without. Conclusion: Serum ALP concentration exceeding 700 IU/L at 3 weeks post‐natal age can predict the risk of osteopaenia in preterm infants.     

3岁以下儿童铅中毒临床分析

目的 了解婴幼儿铅中毒状态及程度。 方法 对前来保健门诊健康体检的4 543例3岁以下儿童进行血铅含量测定,并将婴幼儿分为1个月-、6个月-、12个月-、18个月-、24个月-、30-36个月6组。以SAS 8.0统计软件进行统计分析。结果 铅中毒检出率为2.05%,3岁以下儿童血铅水平随月龄的增长而增高。结论 在接受血铅水平检测的婴幼儿中,高铅血症的检出率随年龄增长而增加,铅中毒则年龄越小检出率越高。要注意控制婴幼儿接触铅的各种途径。     

Bone isoenzyme of serum alkaline phosphatase and serum inorganic phosphate in metabolic bone disease of prematurity

We wanted to improve detection of low bone mineral density in preterm infants by combining serum measurements of total alkaline phosphatase, its bone-type isoenzyme and serum inorganic phosphate in a prospective design. The subjects were 43 preterm infants. Total and bone isoenzyme activity of alkaline phosphatase was determined at 3 wk chronological age and at 3 and 6 mo corrected age. The main outcome measure, apparent bone mineral density (BMAD) at the distal forearm and forearm shaft, was assessed by dual energy X-ray absorptiometry at 3 and 6 mo corrected age. An apparent density below 95 mg/cm³ at 3 mo corrected age was considered to indicate bone disease, based on the distribution of BMAD values of children with non-complicated courses of prematurity. At 3 mo corrected age, total alkaline phosphatase activities exceeding 900 IU/l revealed low bone mineral density with 88% sensitivity and 71% specificity. Measurements of bone isoenzyme activity did not improve diagnostic performance. Serum inorganic phosphate levels below 1.8 mmol/l reflected low bone density with high specificity (96%), but the sensitivity was only 50%. Conclusion: A combination of the criteria “serum total alkaline phosphatase activity above 900 IU/l” and “serum inorganic phosphate concentrations below 1.8 mmol/l” yielded a sensitivity of 100% at a specificity of 70%. This was the best available screening method for low bone mineral density in preterms.     

新生儿脐血铅水平与骨代谢指标变化的相关性研究

目的探讨新生儿脐血铅水平与骨代谢指标间的相关性。方法采集80例正常新生儿脐静脉血5ml,分别检测血铅、血清骨钙素（OC）、骨碱性磷酸酶（ALP）及25-（OH）D3。结果脐血铅水平与胎儿OC、25-（OH）D3呈显著负相关,与ALP呈显著正相关。以P50（50.45μg/L）为界,较高脐血铅组血清OC[（10.0±5.84）ng/ml]、25-（OH）D3[（47.52±28.82）μg/L]均显著低于较低脐血铅组血清OC[（19.26±4.32）ng/ml,P〈0.001]、25-（OH）D3[（56.62±26.80）μg/L,P〈0.05];高血铅组骨ALP水平[（182.64±44.67）U/L]显著高于低血铅组[（126.43±62.05）U/L,P〈0.05）]。结论胎儿期低水平铅暴露可能影响骨形成过程,阻碍正常骨矿化过程。     

Increased respiratory burst response and alkaline phosphatase activity in human cord blood neutrophils

The priming effect of a bacterial lipopolysaccharide (LPS) on subsequent respiratory burst activity induced by either the chemoattractant formylmethionyl-leucyi-phenylalaninc (fMLP) or phorbol myristate acetate (PMA; a protein kinase C activator) was studied in human ncutrophils isolated from cord blood and adult peripheral blood. Cells from adults, but not from newborn babies, were primed by LPS pretreatment. The content and release of β-glucuronidase and vitamin-B12 binding protein, or marker for the azurophilic and specific granules, respectively, was similar for cells from infants and adult controls. In contrast, alkaline phosphatase activity was significantly increased in the cord blood neutrophils compared to neutrophils from adult peripheral blood. The latency of the alkaline phosphatase activity was, however, similar. Thus, the primed response of cord blood neutrophils could not be explained by an increased release of azurophilic or specific granule content. If the increased alkaline phosphatase activity of curd cells represents an increased number of secretory vesicles, however, then this would indicate a rapid turnover leading to delivery of new receptors and oxidase components to the cell membrane.     

Cotside plasma rather than whole blood estimates of blood glucose in the newborn

Abstract An evaluation of the use of a glucose reflectance meter for the cotside measurement of plasma rather than whole blood glucose was undertaken. Three hundred and twelve samples were obtained for examination. There is a closer correlation between plasma glucose than whole blood glucose to laboratory values. Confidence and prediction intervals show that even separating plasma from whole blood at the cotside does not improve the reliability of glucose reflectance meters when predicting blood glucose values in the context of managing high risk newborn infants. The cotside measurement of blood glucose using glucose reflectance meters should be abandoned and improved methods for quickly obtaining accurate laboratory data should be instituted.     

Phosphate, alkaline phosphatase and bone mineralization in preterm neonates

We examined the relationship between bone mineralization, measured by single photon absorptio-metry, and blood phosphate and alkaline phosphatase concentration in 71 preterm neonates. Although both alkaline phosphatase and phosphate concentrations were significantly related to bone mineral content, and alkaline phosphatase concentrations were related to bone mineral content relative to weight, each could only explain a small amount of the variation in bone mineralization. Hence, concentrations of neither could be used to identify those neonates with the greatest bone mineral deficits.     

谷氨酸和一氧化氮与新生儿缺氧缺血性脑病的关系探讨

为探讨脑脊液谷氨酸和一氧化氮（NO）水平变化在新生儿缺氧缺血性脑病（HIE）中的作用及相互关系。对24例HIE新生儿脑脊液谷氨酸和NO水平进行检测,并与8例对照组比较。结果：中、重度HIE组脑脊液谷氨酸和NO水平明显高于对照组及轻度HIE组;谷氨酸和NO呈显著正相关,提示谷氨酸和NO在新生儿HIE的发生和发展过程中具有重要意义。     

新生儿血、尿抗菌物质的检测及其临床意义

目的了解我国住院新生儿使用抗生素前血、尿中存在抗菌物质的情况,并探讨其对血培养结果的影响。方法用微球菌琼脂扩散法检测血、尿标本中是否存在抗菌物质,出现任何抑菌环均认为应用过抗生素。结果123例血标本中抗菌物质检测阳性73例(59.3％),34例尿标本中32例(94.1％)阳性。家长承认入院前用过抗生素者仅35例(28.4％)。临床疑有败血症40例,其中血抗菌物质检测阳性23例(57.5％)中血培养阳性仅5例(21.7％);而血抗菌物质检测阴性17例(42.5％)中血培养阳性12例(70.6％),两者比较有显著差异(P＜0.01)。瑞典新生儿8例尿抗菌物质检测均为阴性。结论抗生素在我国新生儿疾病中广泛应用,家长提供的病史并不可靠,血、尿中存在抗菌物质会降低血培养的阳性率。血、尿抗菌物质检测可作为判断血培养结果的辅助方法。