广东省湛江市早产儿代谢性骨病发病情况及临床特征分析

目的:分析广东省湛江市早产儿代谢性骨病发病情况及临床特征。方法:于2016年12月至2018年11月选取我院120例早产儿进行代谢性骨病发病情况及临床特征分析,观察早产儿中代谢性骨病发病率、治疗前后早产儿代谢性骨病患儿发育情况及骨折率。结果:120例早产儿中发生代谢性骨病的患儿共计12例,发病率为10.00%,其中在极低/超低出生体重儿组中共有5例代谢性骨病患儿,发病率为19.23%,在低出生体重儿组中共有7例代谢性骨病患儿,发病率为9.33%,正常体重组患儿无代谢性骨病发生;12例代谢性骨病患儿身长、体重、头围在治疗后明显增长,骨折率显著降低。结论:极低/超低出生体重早产儿代谢性骨病发生率最高,经治疗后代谢性骨病患儿发育情况及骨折率均得到显著改善。     

新生儿骨矿代谢临床研究

目的 了解不同分类新生儿的骨矿代谢状况,并对比各项骨矿代谢指标在骨营养代谢异常中的诊断价值,为早期干预提供依据。方法 选取90例新生儿,其中足月儿62例、早产儿28例(极低出生体重儿12例,低出生体重儿16例)作为研究对象。检测血清骨钙素(OC)、β胶原分解片段(β-CTx)、血清钙(Ca²⁺)、25-羟胆骨化醇[25-(OH)D₃]及甲状旁腺素(PTH)浓度,并采用两组独立样本t检验及Pearson相关分析对检测结果进行统计学分析。结果 早产儿组血清β-CTx浓度高于足月儿组(P<0.05),血清Ca²⁺和PTH浓度低于足月儿组(P分别<0.01和<0.05);早产儿组血清OC水平与Ca²⁺、25-(OH)D₃呈正相关,血清β-CTx水平与Ca²⁺和25-(OH)D₃呈负相关;极低出生体重(VLBW)组血清OC与Ca²⁺浓度低于低出生体重(LBW)组(P均<0.05),血清β-CTx浓度高于LBW组(P<0.05); VLBW组血清OC水平与Ca²⁺、25-(OH)D₃呈正相关,血清β-CTx水平与Ca²⁺、25-(OH)D₃呈负相关;新生儿血清OC、Ca²⁺水平与胎龄、体重正相关,血清β-CTx水平与胎龄、体重负相关。结论 新生儿血清骨矿代谢指标水平主要受胎龄、体重因素的影响,早产儿易出现骨营养代谢异常,且胎龄越小(体重越轻)越易出现骨营养代谢异常,临床上应尽早发现并及时合理补充VitD和钙。     

维生素D水平与极低出生体重儿临床结局的相关性研究

目的分析出生时血清25-羟维生素D[25-(OH)D]水平对极低出生体重儿临床结局的影响,为早产儿相关疾病的预防和治疗提供新的方向。方法选取2019年9月-2020年9月在济宁医学院附属医院NICU住院治疗的105例极低出生体重儿为研究对象,根据出生24 h内血清25-(OH)D水平,将患儿分为维生素D严重缺乏组(A组)、维生素D缺乏组(B组)及维生素D正常组(对照组),对三组母婴一般资料、住院期间的治疗情况、合并症及临床转归进行比较。结果所有患儿出生时血清25-(OH)D平均值为(14.33±3.60)ng/ml,维生素D缺乏的发生率为79.1%。夏秋季节出生的患儿血清25-(OH)D明显高于冬春季节(t=2.71,P=0.01)。A组、B组患儿的出生体重、出生体重Z评分及1 min Apgar评分均较对照组低(F=0.86、 5.43、9.05,P<0.01)。母亲年龄越大,维生素D水平越低,差异有统计学意义(F=8.40,P<0.01)。A组、B组患儿住院时间、用氧时间、机械通气时间、无创通气时间均高于对照组,差异有统计学意义(F=19.65、7.45、15.97、4...     

磷 碱性磷酸酶及甲状旁腺激素在代谢性骨病早产儿中的表达与意义

目的 研究磷、碱性磷酸酶(AKP)及甲状旁腺激素(PTH)在代谢性骨病早产儿中的表达与意义。方法 选取2019年9月—2022年3月义乌市中心医院就诊的90例代谢性骨病早产儿作为研究组,另选取同期进行正常体检的同日龄正常足月新生儿50例作为对照组。采集两组静脉血,检测血清磷、AKP、PTH水平,分析血清磷、AKP、PTH水平与早产儿发生代谢性骨病的关系。结果 对照组血清磷、AKP、PTH水平分别为(5.69±1.65)mg/dl、(213.64±12.65)U/L、(152.64±12.36)mg/dl;研究组血清磷、AKP、PTH水平分别为(3.03±1.03)mg/dl、(487.65±23.26)U/L、(223.65±26.35)mg/dl。与对照组相比,研究组患儿血清磷水平较低,AKP、PTH水平较高,差异均有统计学意义(t=11.740,77.120,17.970,均P<0.05)。logistic回归分析结果显示：成纤维细胞生长因子-23(FGF-23)、25-羟维生素D₃[25(OH)D₃]、Ⅰ型前胶原氨基端前肽(PIN...     

高出生体重对儿童期血压影响的队列研究

目的 探讨高出生体重对儿童期血压的影响。方法对无锡市1993—1995年建立的高出生体重(暴露组)队列于2005-2007年进行随访,每个暴露对象按“出生日期±2个月”、“性别”匹配一个非暴露(正常体重儿)。共随访到1435对研究对象,对其进行问卷调查,测量身高、体重、血压。结果 高出生体重组的收缩压中位数为100mmHg(Q₁一Q₃：90—110lnmHg),舒张压为64nlnlHg(Q₁～Q₃：60一70mlTlHg);正常体重儿组的收缩压为100inn]Hg(Q₁～Q,：90—108 rnrnHg),舒张压为62mmHg(Q₁～Q,：60。70i/lmHg),两组相比差异均无统计学意义。暴露组“血压升高”(高血压前期和高血压)的比例为13.66%非暴露组为11.57%(P=0.055)。调整儿童期体重指数、性别、儿童随访时年龄、母亲生育年龄、孕龄、婴儿喂养方式、儿童期是否有挑食习惯、儿童期运动时间的多因素二项式回归模型显示,高出生体重导致血压升高的RR值为1.06(0.92～1.21),未达到统计学显著水平。结论 未发现高出生体重与儿童期血压有显著关联。     

早产儿血清维生素D水平与院内感染的关系研究

目的探讨早产儿出生时血清维生素D水平与院内感染的关系。 方法选取2011年1月1日至2015年12月31日,于南京医科大学附属无锡妇幼保健院新生儿重症监护病房(NICU)接受治疗的出生胎龄<32周的246例早产儿为研究对象。根据早产儿是否发生院内感染,将其分为院内感染组(n＝63)与对照组(n＝183)。对于院内感染组早产儿,根据其感染类型,进一步分为败血症亚组(n＝27)与其他感染亚组(n＝36)。采用化学发光免疫分析法,检测所有早产儿出生时血清25-羟基维生素D[25(OH)VitD]水平。对院内感染组与对照组、不同亚组与对照组早产儿出生时血清25(OH)VitD水平及维生素D缺乏发生率,分别采用Wilcoxon秩和检验和χ²检验进行统计学分析。本研究遵循的程序获得南京医科大学附属无锡妇幼保健院伦理委员会审查(审批文号：2013-01-1015-01)。 结果①院内感染组与对照组早产儿的出生胎龄、出生体重,性别、出生季节、母亲分娩方式构成比,母亲年龄、早孕期人体质量指数(BMI)、妊娠期糖尿病、妊娠期高血压疾病、绒毛膜羊膜炎发生率等一般临床资料比较,差异均无统计学意义(P>0.05)。②这246例早产儿出生时,维生素D缺乏发生率为45.5%(112/246),院内感染发生率为25.6%(63/246)。院内感染组和对照组早产儿出生时,血清25(OH)VitD浓度及维生素D缺乏发生率分别比较,差异均无统计学意义(P>0.05)。③败血症亚组早产儿出生时,血清25(OH)VitD浓度为28.1 nmol/L(23.5～34.1 nmol/L),显著低于对照组的32.7 nmol/L(25.3～45.4)nmol/L,并且差异有统计学意义(Z＝－2.011,P＝0.044)。败血症亚组早产儿出生时,维生素D缺乏发生率为70.4%(19/27),显著高于对照组的43.2%(79/183),并且差异亦有统计学意义(χ²＝6.995,P＝0.008)。其他感染亚组与对照组早产儿出生时,血清25(OH)VitD浓度及维生素D缺乏发生率分别比较,差异均无统计学意义(P>0.05)。 结论早产儿出生时血清25(OH)VitD水平可能与院内感染发生率无相关性。维生素D缺乏可能增加早产儿院内感染败血症发生率。因为本研究纳入样本量相对较小,早产儿出生时血清25(OH)VitD水平与院内感染的关系,仍需大样本、多中心、随机对照试验进一步研究、证实。     

西安市早产儿代谢性骨病患病影响因素的病例对照研究

目的 分析早产儿代谢性骨病(metabolic bone disease of prematurity,MBDP)患病的相关危险因素,为临床早产儿代谢性骨病的早期发现与预防提供临床依据。方法 采用病例对照研究方法,病例来源于2017年1月—2019年3月在西安市第四医院新生儿重症医学科就诊的早产儿代谢性骨病新生儿,以1∶1配比选取同期出生并在新生儿科入院的新生儿为对照,收集两组研究对象一般资料及相关临床资料,并采用调查问卷法收集婴儿母亲妊娠期的相关情况,通过组间比较对早产儿代谢性骨病的相关危险因素进行单因素分析和多因素logistic回归分析。结果 病例组与对照组研究对象在胎龄、出生体重、肠外营养时间、机械通气时间、住院时间、合并宫内生长发育迟缓(intrauterine growth restriction,IUGR)、合并感染、利尿剂应用、咖啡因应用、地塞米松应用、胆汁淤积症、支气管肺发育不良、癫痫发作等方面差异均有统计学意义(均P＜0.05);将研究对象母亲妊娠期间情况进行比较分析发现,病例组与对照组研究对象母亲妊娠期高血压、妊娠期糖尿病、妇科炎症及胎膜早破等方面差异均有统计学意义(均P＜0.05);多因素logistic回归分析结果提示胎龄(＜32周,OR=6.521)、出生体重(<1 500 g,OR=3.980;<1 000 g,OR=17.047)、肠外营养(≥2周,OR=3.473)、IUGR(OR=5.778)、胆汁淤积症(OR=2.071)、利尿剂的应用(OR=7.698)均为新生儿代谢性骨病发病的独立危险因素(均P＜0.05)。结论 早产儿代谢性骨病与其胎龄、体重、IUGR、出生后肠外营养时间过长、合并胆汁淤积症、应用利尿剂等因素有关,应针对相应危险因素加强孕期保健,减少早产、IUGR等情况的发生,避免延长不必要的临床治疗,尽早开始肠内营养,以减少MBDP的发生。     

妊娠期PM2.5暴露影响胎儿生长的前瞻性队列研究

目的 探讨妊娠期PM_2.5及其组分暴露对胎儿生长的影响,并进一步识别暴露效应窗口。方法 选取江苏出生队列2016年1月至2019年10月招募的4 089对母子对,收集其基线信息、妊娠期诊疗信息、妊娠期PM_2.5及其组分暴露信息、妊娠满20周后的胎儿B超检查（头围、腹围、股骨长和估计体重）信息。利用广义线性混合模型进行暴露效应的估计,利用分布滞后非线性模型探讨暴露效应窗口。结果 妊娠期PM_2.5暴露浓度每升高10 μg/m³,胎儿头围、腹围和估计体重Z评分分别减小0.025（β=-0.025,95%CI：-0.048~-0.001）、0.026（β=-0.026,95%CI：-0.049~-0.003）和0.028（β=-0.028,95%CI：-0.052~-0.004）,头围和估计体重生长受限风险分别增加8.5%（RR=1.085,95%CI：1.010~1.165）和13.5%（RR=1.135,95%CI：1.016~1.268）。PM_2.5组分中黑碳、有机物、硝酸盐、硫酸盐、铵盐暴露浓度升高均与头围Z评分减小显著相关,同时硫酸盐暴露的增加还与股骨长的Z评分减小有关。妊娠期PM_2.5暴露影响胎儿头围生长效应窗口为第2~5周,腹围为第4~13周以及第19~40周,股骨长为第4~13周以及第23~37周,估计体重为第4~12周以及第20~40周。结论 妊娠期PM_2.5及其组分暴露可能对胎儿生长产生不利影响,影响胎儿不同生长指标的效应窗口不完全一致。     

早产儿脐血血清25羟维生素D与呼吸窘迫综合征的关联性研究

目的 探讨早产儿脐血血清25羟维生素D[25(OH)D] 水平与呼吸窘迫综合征(RDS)的关系,为RDS的临床预防提供新思路。方法 将2018年3月—2020年5月收治入复旦大学附属妇产科医院NICU的179例早产儿纳入分析,于出生时采集脐血,使用化学发光微粒子免疫检测法分析测定脐血血清25(OH)D水平。根据是否诊断RDS分为RDS组和对照组,将血清25(OH)D水平是否低于20 ng/ml分为维生素D减少组和充足组,并分别分析和比较两组各影响因素的差异。结果 25.1%早产儿脐血25(OH)D水平缺乏(<10 ng/ml)、42.5%不足(10~<20 ng/ml),32.4%正常(≥20 ng/ml)。RDS组脐血血清25(OH)D水平[(11.3±7.2) ng/ml]显著低于对照组[(15.88±8.4)nmol/L], t=3.469,P<0.01);RDS组脐血血清25(OH)D减少发生率为89.0%(121/136),显著高于对照组 [46.5%(20/43), χ²=35.221, P<0.01)]。通过单因素和多因素分析,新生儿胎龄≤32周和脐血血清25(OH)D<20 ng/ml是早产儿发生RDS的独立危险因素(OR=39.694, 5.696, P＜0.05)。结论 早产儿维生素D缺乏发生率高,低维生素D水平可能增加RDS发生率。     

早产儿支气管肺发育不良的临床影响因素研究

目的探讨早产儿支气管肺发育不良(BPD)的临床影响因素。方法选取在该院新生儿重症监护病房(NICU)接受治疗的被诊断为BPD的85例早产儿作为观察组,在未发生BPD的早产儿中选取患儿母亲一般情况及患儿出生情况相匹配的85例作为对照组。对两组早产儿的一般情况、原发疾病/并发症、治疗情况、新生儿危重病例评分(NCIS)、血清25-羟维生素D[25-(OH) D]及母亲血清25-(OH) D水平进行对比,分析BPD的相关影响因素。结果观察组早产儿呼吸窘迫综合征(NRDS)、呼吸机相关肺炎(VAP)、电解质紊乱、重度脑室周—脑室内出血(PVH-IVH)、动脉导管未闭(PDA)、胃肠道外营养相关胆汁淤积(PNAC)、有创通气、输血≥3次、手术治疗发生率均显著高于对照组,开始肠内喂养时间明显长于对照组(P0. 05)。观察组早产儿血清25-(OH) D、母亲血清25-(OH) D水平及NCIS评分均显著低于对照组(P0. 05)。多因素回归分析显示:PDA、电解质紊乱、有创通气、手术治疗均是BPD发生的独立高危因素,早产儿血清25-(OH) D、母亲血清25-(OH)D、NCIS评分均是BPD发生的保护性因素(均P0. 05)。结论 PDA、电解质紊乱、有创通气、早产儿及母亲维生素D缺乏、NCIS评分低下均是影响早产儿发生BPD的临床高危因素,孕妇尽早补充维生素D对于预防早产儿BPD的发生具有积极作用。     

A new method for the determination of vitamin D3 and 25-hydroxyvitamin D3 in meat

The total vitamin D content in meat, i.e., vitamin D₃ and 25-hydroxyvitamin D₃, was determined by HPLC after alkaline hydrolysation, solid-phase extraction and semi-preparative HPLC. For detection, a DAD detector between 220 and 320 nm was used and quantification was performed at 265 nm. Vitamin D₂ was used as internal standard for vitamin D₃ as well as for 25-hydroxyvitamin D₃. Precision for vitamin D₃ was determined in lean meat and lard to 9.1% and 7.1%, respectively. The corresponding values for 25-hydroxyvitamin D₃ were 8.9% and 9.9%. Accuracy was determined in spiked samples, which showed a recovery of 94.7% and 99.0% for vitamin D₃ and 25-hydroxyvitamin D₃, respectively. The method is applicable for establishing data for food composition tables.     

Elevated Alkaline Phosphatase in Infants With Parenteral Nutrition–Associated Liver Disease Reflects Bone Rather Than Liver Disease

Background: Elevated serum alkaline phosphatase (ALP) in infants with intestinal failure (IF) can be due to parenteral nutrition–associated liver disease (PNALD) or metabolic bone disease (MBD). The purpose of the study was to determine the utility of serum ALP in the diagnostic criteria for PNALD by measuring tissue‐specific levels in infants with IF and PNALD. Methods: A retrospective review of patient data for 15 infants diagnosed with PNALD between December 2012 and August 2013 was performed. PNALD was defined as the presence of 2 consecutive direct bilirubin (DB) levels >2 mg/dL. Fractionated serum alkaline phosphatase was measured in each patient, while the DB was >2 mg/dL. Parathyroid hormone (PTH), vitamin D₃, calcium, and phosphate levels were recorded where available. Results: In 15 infants with PNALD, elevation in total ALP was due to marked elevations in bone‐specific ALP. The median liver‐specific ALP remained within the normal range. PTH, vitamin D₃, calcium, and phosphate levels were within normal limits. Conclusion: While elevated ALP can reflect biliary stasis, the ALP elevation observed in infants with IF and PNALD is predominantly of bone rather than hepatic origin. An elevated unfractionated ALP in infants with PNALD should therefore raise suspicion of underlying bone disease, rather than being attributed to liver disease alone.     

Is a daily supplementation with 40 microgram vitamin D3 sufficient? A randomised controlled trial

Purpose

The effect of 40?μg (1,600?IU) per day of vitamin D₃ on serum 25-hydroxyvitamin D (25(OH)D) and markers of bone and mineral metabolism was evaluated.

Methods

This intervention study was designed as a double-blind randomised controlled trial. Forty-five community-dwelling subjects (32 females), age 55–84?years, at 58° North latitude were supplemented for 1?year with 40?μg vitamin D₃ plus 1,000?mg calcium per day, or with 1,000?mg calcium per day for controls. Safety parameters and 25(OH)D, intact parathyroid hormone (PTH), ionized calcium, bone-specific alkaline phosphatase (BALP), and tartrate-resistant acid phosphatase isoform 5b (TRACP5b) were measured over the study period.

Results

All subjects supplemented with vitamin D₃ reached a 25(OH)D level above 50?nmol/L. Mean (SD) serum 25(OH)D increased from 50.4 (13.5) nmol/L to 84.2 (17.5) nmol/L, range 55.0–125.0?nmol/L in the vitamin D₃ supplemented group and the corresponding levels for the control group were 47.3 (14.1) nmol/L and 45.7 (13.4) nmol/L, range 26.0–73.0?nmol/L. No serious adverse event was recorded and the highest 25(OH)D level reached, 125.0?nmol/L, is well below toxic levels. BALP and TRACP5b did not change significantly over the study period.

Conclusions

This trial suggests that a daily supplementation with 40?μg vitamin D₃ is sufficient to secure a 25(OH)D level of 50?nmol/L. No side effects were observed in the study group.     

Association of Dietary Vitamin D Intake,Serum 25(OH)D3, 25(OH)D2 with Cognitive Performance in the Elderly

Background: As life expectancy increases, cognitive performance decline in the elderly has become one of the major global challenges. We aimed to evaluate the association of dietary vitamin D (VD), serum 25-hydroxyvitamin D3 (25(OH)D₃), 25-hydroxyvitamin D2 (25(OH)D₂), and total 25-hydroxyvitamin (25(OH)D) concentration with cognitive performance in older Americans. Methods: The data from the National Health and Nutrition Examination Survey (NHANES), 2011–2014 was used. The cognitive performance was assessed by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning sub-test, Animal Fluency test, and Digit Symbol Substitution Test (DSST). A binary logistic regression model was applied to evaluate the association between VD and cognitive performance, and restricted cubic spline model was adopted to evaluate the dose–response relationship. Results: While comparing to the lowest dietary VD intake group, the multivariate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of the highest dietary VD intake group were 0.51 (0.36–0.72) for the Animal Fluency test score and 0.45 (0.31–0.66) for DSST score, respectively; and those of serum total 25(OH)D and 25(OH)D₃ concentration were 0.68 (0.47–0.97) and 0.62 (0.44–0.86) for DSST score. L-shaped relationships were identified for dietary VD intake, serum total 25(OH)D and 25(OH)D₃ concentration with cognition performance. The associations between dietary VD intake, serum total 25(OH)D and cognitive performance were non-significant when stratified by gender. Conclusions: The study indicates that dietary VD intake, serum total 25(OH)D and 25(OH)D₃ concentration were positively associated with cognitive performance. Further studies are needed to clarify the possible effects of dietary VD intake and serum 25(OH)D₂, 25(OH)D₃ on cognitive performance.     

不同随访模式早产儿生后6至12月营养相关指标的对比研究

目的 监测规律随访与未规律随访模式早产儿生后6~12月间(矫正月龄)血清25-羟维生素D₃[25-(OH)D₃]、钙(Ca)、磷(P)、碱性磷酸酶(ALP)、尿素(UREA)、前白蛋白(PA)的水平,探讨两种随访模式对早产儿营养状况的影响及其安全性。方法 回顾性分析2015年1月-2017年12月在陆军军医大学第二附属医院院门诊就诊的143例早产儿资料,其中定期规律随访者79例设为A组,另外因各种原因未能定期规律随访者64例设为B组,同时将同期在本院儿保门诊随访的足月健康婴儿253例设为C组。婴儿于出生第6月至第12月(早产儿为矫正月龄)间抽血查血清25-(OH)D₃、Ca、ALP、P、UREA、PA水平。结果 1)A组及C组的血清25-(OH)D₃、Ca、PA均显著高于B组(P<0.05)。A组的血清25-(OH)D₃高于C组,差异具有统计学意义(P<0.05)。A、B、C三组间血清ALP、P、UREA差异无统计学意义(P>0.05)。2)A、B、C三组25-(OH)D₃测值评价结果比较:三组均无中毒病例,评价为25-(OH)D₃值适宜的例数A组最多,B组最少。结论 1)定期规律随访并按儿保建议喂养的早产儿,其生后6至12月血清25-(OH)D₃缺乏及低前白蛋白血症发生率低。2)早产儿喂养方案需个体化。3)部分早产儿营养评价指标(如:ALP)缺乏参考标准,仍需完善。     

Single high-dose vitamin D at birth corrects vitamin D deficiency in infants in Mexico

Abstract

This study examined the prevalence of vitamin D deficiency in mothers and infants in Tijuana, Mexico and determined the effect of a single oral dose of 50?000?IU vitamin D₃ at birth on 25-hydroxyvitamin D (25[OH]D) levels during infancy. Healthy infants were randomized to receive vitamin D₃ or placebo at birth. At birth 23% of infants were vitamin D deficient and 77% had vitamin D insufficiency (mean 25[OH]D level 18.9?ng/ml); 10% of mothers were vitamin D deficient and 61% were insufficient. Infants receiving vitamin D₃ had higher 25(OH)D levels at two months (N?=?29; 33.9 versus 24.2?ng/ml) and six months (N?=?21; 36.5 versus 27.4?ng/ml). Exclusively breastfed infants had lower 25(OH)D levels at two months (14.9 versus 33.4?ng/ml). Vitamin D deficiency is common in infants and mothers in Tijuana, Mexico. A single dose of vitamin D₃ at birth was safe and significantly increased 25(OH)D levels during infancy.     

Oxidative stress induced by gibberellic acid in bone of suckling rats

The present study investigates the bone maturity of suckling rats whose mothers were treated with gibberellic acid (GA₃). Female Wistar rats were divided into two groups: group I that served as controls and group II that received orally GA₃ (200 ppm) from the 14th day of pregnancy until day 14 after delivery. In the GA₃ group, an increase in body and femur weights as well as in femur length of pups was noted when compared to controls. Lipid peroxidation was demonstrated by high femur malondialdehyde levels, while superoxide dismutase, catalase, glutathione peroxidase activities, glutathione and vitamin C levels in femur decreased. GA₃ caused a decrease in calcium and phosphorus levels in bone. The calcium concentration in plasma increased and the phosphorus concentration decreased, while urinary levels of calcium decreased and those of phosphate increased. Moreover, plasma total tartrate-resistant acid phosphatase and total alkaline phosphatase increased. Bone disorders were confirmed by femur histological changes.     

葛根素联合雌二醇对去卵巢大鼠骨组织及血钙、磷和碱性磷酸酶的影响

目的:了解小剂量葛根素联合雌二醇对去卵巢大鼠的骨组织、血钙、磷和碱性磷酸酶的影响,为中西医结合治疗绝经后骨质疏松症提供实验依据。方法:5月龄健康雌性大白鼠120只,分成5个实验组(每组24只):①假手术组(sham);②去卵巢模型组(OVX);③葛根素组(Pr),皮下注射葛根素,50 mg/kg,1次/d;④雌二醇组(E2),皮下注射雌二醇200μg/kg,2次/周;⑤小剂量葛根素+雌二醇组(Pr+E2),皮下注射雌二醇100μg/kg,2次/周和葛根素25 mg/kg,1次/d。各实验组在第4、8、12和20周,随机取6只大鼠取股骨切片观察骨组织,采血测量血钙、磷和碱性磷酸酶,数据进行统计学分析。结果:OVX组第4、8、12、20周的骨组织呈骨质疏松病理改变,血钙、磷明显低于sham组(P﹤0.01),OVX组的第4、8、12、20周血碱性磷酸酶均明显高于sham组(P﹤0.01)。3个治疗组各时间的骨组织和血钙、磷和碱性磷酸酶与sham组无统计学意义(P﹥0.05)。小剂量的葛根素联合雌二醇治疗能使去卵巢大鼠骨组织和血钙、磷和血碱性磷酸酶基本恢复正常(P﹥0.05),与较大剂量的葛根素组或较大剂量的雌二醇组相比无统计学意义(P﹥0.05)。结论:小剂量的雌二醇与葛根素对去卵巢大鼠的骨质疏松症的治疗效果与单独使用较大剂量的葛根素或较大剂量的雌二醇相比治疗效果相近。     

扬州市早产儿血清钙、磷、碱性磷酸酶以及维生素D水平状况分析

目的 探索不同出生孕周、体重和出生季节的早产儿其血清钙(calcium,Ca),磷(phosphorus,P),碱性磷酸酶(alka-line phosphatase,ALP)以及维生素D(vitamin D,VD)水平的情况.方法 选取扬州市妇幼保健院新生儿科2018年6月-2019年7月出生的早产儿共计488例作为...     

Serum 25-hydroxyvitamin D3 levels are elevated in South Indian patients with ischemic heart disease

Several lines of evidence point to a possible relationship between vitamin D and cardiovascular disease. Animal experiments and observational studies in humans suggest vitamin D to be arteriotoxic and an association of high intake of vitamin D with increased incidence of ischemic heart disease (IHD). The major source of vitamin D in adults is vitamin D synthesized in the skin through exposure to the sun. In tropical environment there is a possibility of high level of solar exposure and enhanced serum levels of vitamin D in the population. We explored the relation between serum level of 25-hydroxyvitamin D₃ and IHD in a case-control study involving 143 patients with either angiographic evidence of coronary artery disease or patients with acute myocardial infarction and 70 controls, all men in the age group of 45–65 years. Fasting blood samples were collected, serum separated and serum levels of 25-hydroxyvitamin D₃ was measured by protein binding radioligand assay. Serum levels of cholesterol, triglyceride, calcium, magnesium and inorganic phosphate were also determined. Prevalences of diabetes, hypertension and smoking history were noted. Statistical comparisons of variables between cases and controls were done using ²-tests. Multivariate logistic regression analysis was done to examine the association of IHD with serum levels of 25-hydroxyvitamin D₃ controlling for selected variables. Serum levels of 25-hydroxyvitamin D₃, calcium, inorganic phosphate, total cholesterol, low density lipoprotein and triglycerides were elevated in a higher proportion of patients, compared to controls. Serum levels of 25-OH-D₃ above 222.5 nmol/l (89 ng/ml) was observed in 59.4% of cases compared to 22.1% in controls (p < 0.001; unadjusted odds ratio (OR): 5.17; 95% confidence interval (CI): 2.62–10.21). When controlled for age and selected variables using the multivariate logistic regression, the adjusted OR relating elevated serum 25-hydroxyvitamin D₃ levels ( 222.5 nmol/l, 89 ng/ml) and IHD is 3.18 (95% CI: 1.31–7.73). Given the evidences for the arteriotoxicity of vitamin D, further investigations are warranted to probe whether the elevated serum levels of 25-hydroxyvitamin D₃ observed in patients with IHD in a tropical environment has any pathogenic significance.