BALPKIT诊断小儿佝偻病1116例病例报导

我院应用中国医学科学院协和医学技术中心实际研究室研制的小儿佝偻病诊断用骨碱性磷酸酶试剂盒,对东胜地区1116名0-6岁儿童进行普查.小儿体内维生素D缺乏,钙、磷吸收减少,从而导致佝偻病发生,儿童生长发育速度快,维生素D需要量大,佝偻病的发生率也高.小儿佝偻病诊断BALPKIT操作简便,不用特殊仪器,特异性强,快速,克服了婴幼儿取血不易的困难,适合基层医疗保健单位在进行儿童体检时开展.     

维生素D2注射液治疗sbJh早期佝偻病疗效观察

维生素D缺乏性佝偻病是由于体内维生素D不足引起钙、磷代谢失调,导致骨骼发生病变,甚至引起神经、肌肉、造血及免疫系统病变的慢些营养性疾病。目前,重度维生素D缺乏性佝偻病已少见,但轻症病例仍较常见。为探讨维生素D2治疗小儿佝偻病的临床疗效,现对我院近年来收治的46例维生素D缺乏性佝偻病患儿的临床资料进行回顾性分析。报告如下。     

婴幼儿维生素 D 缺乏性佝偻病诊断问题的探讨

近年来,我国各地对小儿佝偻病进行了大量的普查和防治工作。由于目前小儿佝偻病轻症多,不典型的多,诊断的标准尚未划一,各地报道的患病率高低不一,因此,本文就婴幼儿维生素 D 缺乏性佝偻病诊断上的一些问题进行初步探讨。     

滋补肝肾中药预防和治疗大鼠佝偻病的实验研究(摘要)

小儿佝偻病在我国有较高的发病率,卫生部列为小儿四病之首。目前临床上应用维生素D对预防和治疗维生素D缺乏性佝偻病有明显效果。但长期大剂量应用有一定副作用,容易引起维生素D使用过量或中毒。根据中医“肾主骨”、“肾为先天之本”的理论,设计以佝偻病大鼠为模型,利用滋补肝肾中药预防和治疗佝偻病,测量血清钙、血磷、碱性磷酸酶的变化,并对其机理作用进行探讨。     

豫东农村小儿维生素D缺乏性佝偻病相关因素调查分析

目的调查豫东农村小儿维生素D缺乏性佝偻病相关因素。方法以豫东农村3810名小儿的母亲为调查对象,对整群随机抽样问卷的资料进行分析。结果3810名小儿中,维生素D缺乏性佝偻病887例(23.33%),其中男426例,女461例,男女患病在性别上无显著差异。佝偻病患病与喂养方法、辅食添加、母亲文化程度和卫保知晓度、人均年收入有显著差异。结论小儿维生素D缺乏性佝偻病与豫东农村现实的相关因素有关,应采取相应的对策。     

浅谈小儿佝偻病的预防

佝偻病主要指的是维生素D缺乏性佝偻病,是由于维生素D缺乏引起体内钙、磷代谢紊乱,而使骨骼钙化不良的一种疾病。常见于婴幼儿期,北方发病率高于南方,发病缓慢,不容易引起重视,能使小儿抵抗力降低,容易合并肺炎及腹泻等疾病,影响小儿生长发育。因此,必须积极预防小儿佝偻病的发生。     

抗维生素D性佝偻病的诊断和治疗

<正> 小儿具有明显活动性佝偻病症状、体征、血生化及 X 线骨片改变者,而用一般剂量的维生素 D 治疗无效,必须用大剂量维生素 D治疗才能有效者,过去称为顽固性佝偻病或称难治性佝偻病,现在统称为抗维生素 D 性     

骨碱性磷酸酶、血25-羟维生素D_3联合骨密度对小儿维生素D缺乏性佝偻病的诊断价值

目的探讨血25-羟维生素D_3[25-(OH)D_3]、骨碱性磷酸酶(B-ALP)联合骨密度对小儿维生素D缺乏性佝偻病(佝偻病)的诊断价值。方法选取2014年1月至2016年6月宜城市人民医院收治的疑似佝偻病儿童107例作为研究对象,比较有无佝偻病组的血25-(OH)D_3、B-ALP、钙、磷水平和骨密度。并计算血25-(OH)D_3、B-ALP和骨密度及三者联合诊断佝偻病的诊断效能。结果 107例儿童中,检测出佝偻病患儿41例(38.32%);25-(OH)D_3+B-ALP+骨密度联合诊断佝偻病的灵敏度、准确度、阳性预测值(82.93%、93.46%、100.00%)均明显高于25-(OH)D_3(68.29%、85.98%、93.33%)、B-ALP(56.10%、78.50%、82.14%)和骨密度(51.22%、74.77%、75.00%)单独诊断。结论 25-(OH)D_3是诊断小儿维生素D缺乏性佝偻病的重要指标,联合B-ALP、骨密度可提高诊断的准确性。     

小儿维生素D缺乏性佝偻病的临床诊治分析

目的:探讨小儿维生素D缺乏性佝偻病的临床诊治方法与预后。方法:2012年8月~2013年10月选择我院收治的维生素D缺乏性佝偻病小儿40例作为观察组,同期选择住院的年龄、性别匹配的无佝偻病症状的小儿40例对照组,都进行血清骨碱性磷酸酶测定,同时观察组患者采用中性缓冲磷酸盐溶液与维生素D制剂、钙剂的联合治疗方案。结果:观察组的血清骨碱性磷酸酶含量为234.12±18.32 U/L,明显高于对照组,对比差异有统计学意义(P0.05)。治疗后观察组患儿的有效率为90.0%。结论:小儿维生素D缺乏性佝偻病临床表现为血清骨碱性磷酸酶含量增加,采用综合治疗能取得比较好的预后效果。     

防治维生素D缺乏性佝偻病中存在并需注意的问题

维生素D缺乏性佝偻病是由于维生素D缺乏引起体内钙、磷代谢紊乱，而使骨骼钙化不良的一种疾病。常见于婴幼儿期，北方发病率高于南方，发病缓慢，不容易引起重视，能使小儿抵抗力降低，容易合并肺炎及腹泻等疾病，影响小儿生长发育。因此，必须积极防治。但目前在防治维生素D缺乏性佝偻病中存在的问题制约了佝偻病的防治，使其发病率仍然较高。     

小剂量维生素D注射预防维生素D缺乏性佝偻病效果观察

目的观察小剂量维生素D注射预防婴幼儿维生素D缺乏性佝偻病发病效果。方法我院采取小剂量维生素D注射预防婴幼儿维生素D缺乏性佝偻病3年。结果观察组婴幼儿维生素D缺乏性佝偻病发病率(5.01%)较对照组(11.17%)明显下降,而且没有发生中重症病儿。结论应用小剂量维生素D注射预防婴幼儿维生素D缺乏性佝偻病效果显著,值得推广。     

Relationships between radiological and biochemical evidence of rickets in Asian schoolchildren

One hundred Asian schoolchildren provided evidence of the relationships between radiological and biochemical evidence of rickets in a vitamin D-deficient population. In a retrospective study of the X-rays of 56 children the variables serum alkaline phosphatase, inorganic phosphorus and age provided a discriminant function which correctly classified 10 of 11 children with radiological evidence of rickets and 44 of 45 children with negative or marginally abnormal X-rays. When the discriminant function was applied to a prospective study of 44 children, three children with radiological evidence of rickets were correctly classified together with 38 of the remaining 41 children with negative or marginally abnormal X-rays. Serum alkaline phosphatase was the most important variable in the discriminant analysis, followed by serum inorganic phosphorus and age. Low levels of serum 25-hydroxy vitamin D (25-OHD) are of little value in predicting the severity of radiological evidence of rachitic bone disease in a vitamin D-deficient population.     

Prevention of rickets in Asian children: assessment of the Glasgow campaign

In March 1979 the Greater Glasgow Health Board launched a campaign to reduce the high prevalence of rickets in Asian children in the city. A precampaign survey had shown that voluntary low dose vitamin D supplementation would reduce the prevalence of rickets in Asian children. A survey carried out two and three years after the launch of the official campaign also showed a reduction in the prevalence of rickets in children taking low dose supplements equivalent to about 2.5 micrograms (100 IU) vitamin D daily. There was a considerable reduction in the total prevalence of rickets in this survey compared with the precampaign survey. Hospital discharges of Asian children with rickets declined rapidly after the start of the campaign.     

佝偻病的诊治进展

佝偻病是由于儿童体内维生素D不足,致使钙、磷代谢失常的一种慢性营养性疾病,以正在生长的骨骺端软骨板不能正常钙化,造成骨骼病变为特征。本病可严重影响儿童的生长发育,危害到儿童的健康,是我国重点防治的疾病之一。对佝偻病的早诊断、早治疗显得尤为重要,现将佝偻病的诊治进展科要综述。     

小儿佝偻病发病相关因素调查分析及临床疗效研究

目的:探讨饶平县小儿佝偻病的发病因素及应用不同药物的临床治疗疗效。方法:对120例小儿佝偻病患儿的临床资料进行回顾性分析,通过问卷调查分析其发病的相关因素,比较不同因素与佝偻病发病的关系,并应用不同药物进行治疗,观察其治疗效果。结果:佝偻病的发生与性别、年龄、喂养方式、居住环境、父母健康状况有密切的关系。肌内注射Vit D3对小儿佝偻病具有良好的疗效。结论:肌内注射Vit D3治疗小儿佝偻病疗效确切,使用方便,值得临床广泛推广和使用。     

3岁内儿童维生素D缺乏性佝偻病的影响因素

目的 :探讨可能存在维生素D缺乏的3岁内儿童维生素D缺乏性佝偻病发病率、临床特征及影响因素.方法 :483例可疑维生素D缺乏的3岁内儿童根据年龄分为0~12个月组(n=275),13~24个月组(n=136),25~36个月组(n=72),对比三组儿童佝偻病发病率,分析佝偻病临床特点,并探讨其相关因素.结果 :0~12个月组患病率为50.5%,13~24个月组患病率为39.7%,25~36个月组患病率为23.6%,三组比较0~12个月组患病率高于13~24个月组,而13~24个月组患病率高于25~36个月组,差异具统计学意义;0~12个月组维生素D不足和缺乏率为50.5%(139/275),13-24个月组为39.7%(54/136),25~36个月组为23.6%(17/72),差异具统计学意义;儿童佝偻病主要症状与体征为方颅、肋膈沟,发病率45.7%,其次为单纯神经精神症状及枕秃,发病率21.4%,第三为方颅、肋膈沟合并鸡胸、肋串珠,发病率16.7%;母亲孕期营养状况、出生体重、孕周、双胎、喂养方式、正常添加辅食、合理补充维生素D、光照时间、营养不良、肥胖、晒照皮肤面积、家庭经济状况、居住地、留守儿童、母亲文化程度及反复呼吸道感染等方面比较差异均具有统计学意义.结论 :儿童维生素D缺乏性佝偻病发病率相对较高,该病重在预防,而了解其影响因素对于针对性的早期诊断和干预,降低佝偻病的发生率和严重程度均具有重要临床意义.     

Vitamin-D-deficient rickets in Manitoba, 1972-84.

Vitamin-D-deficient rickets still exists in children in Manitoba and adjacent areas. Between 1972 and 1984, 48 cases were documented at Winnipeg Children's Hospital. The patients ranged in age from 1 to 49 months; 40 were Canadian natives (38 Indians and 2 Inuit), most of whom lived in the Island Lake area of northern Manitoba. Of the 48, 16 had clinical signs of rickets, 12 had tetany due to hypocalcemia and 38 had radiologic evidence of rickets. Hypocalcemia was found in 27, and hypophosphatemia in 19; hyperaminoaciduria was found in 7 of 20. All 48 had elevated serum alkaline phosphatase levels. In addition to rickets, 16 patients aged 12 months or more had evidence of malnutrition. Climate and lifestyle in northern areas of the Canadian midwest result in little or no biosynthesis of vitamin D by solar radiation; therefore, adequate dietary vitamin D intake is essential to prevent deficiency. The diets of pregnant women and infants in these areas are deficient in vitamin D. The authors recommend vitamin D supplements for all pregnant women and infants in areas of risk to eradicate this preventable disease.     

Vitamin D deficiency in mothers of infants with rickets

OBJECTIVE: To identify infants treated for vitamin D deficiency rickets, and to determine the incidence of vitamin D deficiency in their mothers and their mothers' country of origin. DESIGN: A retrospective audit of the medical records of children diagnosed with vitamin D deficiency rickets. Inpatients were identified by discharge diagnoses of vitamin D deficiency or hypocalcaemia and outpatients by pharmacy dispensing of cholecalciferol. SETTING: The Women's and Children's Health Care Network and the Southern Health Care Network (Melbourne, VIC) from June 1994 to February 1999. PATIENTS: 55 children with vitamin D deficiency rickets. RESULTS: Fifty-four of the 55 children were born to mothers with ethnocultural risk factors for vitamin D deficiency. Vitamin D status had been assessed in 31 of the 55 mothers (56%): 25 (81%) had 25-hydroxyvitamin D3 concentrations < or = 25 nmol/L, consistent with osteomalacia. CONCLUSION: Vitamin D deficiency continues to occur in children of migrant families. When infants are diagnosed with vitamin D deficiency, vitamin D levels in their mothers and siblings should also be assessed.     

南宁市江南区0～3岁儿童佝偻病调查分析

目的了解南宁市江南区儿童佝偻病患病情况及其影响因素,为佝偻病的防治提供依据。方法对2011年全年在该社区进行健康检查的3678名0～3岁儿童的资料进行分析,并对母亲进行佝偻病相关因素调查。结果佝偻病的患病率为27．3％,佝偻病患儿骨源性碱性磷酸酶明显升高,其发病与母亲孕期缺VitD、早产、出生低体重、喂养方式、日光照射时间及母亲文化程度等因素有关（P〈0．05）。结论儿童佝偻病的患病率仍然处于较高水平,佝偻病的发生是多因素作用的结果,应加强宣传教育,普及佝偻病的预防知识,合理补充维生素D,预防佝偻病的发生。     

Policy for prevention of Asian rickets in Britain: a preliminary assessment of the Glasgow rickets campaign

Evidence of continuing hospital admissions of patients with Asian rickets and osteomalacia led to a further attempt to provide more effective preventive measures for the Glasgow Asian community. Dose-response studies showed that the equivalent of 10 microgram of vitamin D daily would provide effective prophylaxis, and a general practice survey showed that self-administered vitamin D supplements would reduce the prevalence and severity of Asian rickets. A multidisciplinary working group devised a preventive campaign based on the free issue of vitamin D supplements on demand to children who required them. Supported by a health education programme for community health personnel and the Asian community, the first 16 months of the campaign produced an eight-fold rise in the issue of supplements to older Asian children and a 33% increase in their issue to infants of all ethnic groups. Because more children are receiving vitamin D supplementation the campaign seems likely to reduce the prevalence of Asian rickets in Glasgow.