孤独症谱系障碍患儿血清25(OH)D水平的检测

目的了解孤独症谱系障碍(ASD)患儿维生素D营养状况,探讨维生素D水平与ASD的关系。方法采用高效液相色谱-串联质谱法对117例新诊断的ASD患儿和109例健康对照儿童进行血清25(OH)D检测,并根据血清25(OH)D水平,将维生素D状况分为正常(30 ng/m L)、不足(10~30 ng/m L)和缺乏(10 ng/m L),比较两组儿童维生素D营养状况。结果 ASD患儿25(OH)D水平(19±9 ng/m L)明显低于对照组(36±13 ng/m L),差异有统计学意义(P0.01)。ASD患儿中维生素D缺乏和不足率为89.7%,明显高于对照组(52.3%),差异有统计学意义(P0.01)。结论 ASD患儿存在维生素D缺乏或不足,维生素D缺乏和不足有可能是ASD发病的环境/遗传因素。     

新生儿维生素D水平与孕母维生素D水平的关系

目的 探讨新生儿维生素D 水平与孕母维生素D 水平的相关性。方法 2015 年6 月1 日至7月10 日采集102 名足月单胎新生儿脐静脉血及其孕母静脉血,采用同位素稀释超高效液相色谱串联质谱法测定血清25(OH)D 水平。结果 孕母维生素D 不足者39 例(38.2%),缺乏者25 例(24.5%)。新生儿维生素D 不足者27 例(26.5%),缺乏者66 例(64.7%)。不同血清25(OH)D 水平孕母组新生儿25(OH)D 水平差异有统计学意义(P<0.001)。孕母25(OH)D 水平与新生儿维生素D 水平呈正相关(r=0.914,P<0.001)。孕母25(OH)DROC 曲线预测新生儿维生素D 缺乏(≤ 15 ng/mL)的曲线下面积为0.962,95%CI: 0.930~0.994,P<0.001。孕母血清25(OH)D ≤ 27.55 ng/mL 为界值预测新生儿维生素D 缺乏的灵敏度为97.2%,特异度为80.3%。结论 新生儿维生素D 水平与孕母维生素D 水平正相关;孕母维生素D 水平可预测新生儿维生素D 缺乏。     

婴幼儿反复喘息与血清维生素 D水平相关性研究

目的：探讨婴幼儿反复喘息与血清25-羟维生素D水平之间的相关性,并探讨婴幼儿反复喘息的相关危险因素。方法收集2012年10月至2013年3月在我院哮喘门诊就诊的反复喘息婴幼儿（6～36个月）61例为研究对象;另随机选取同期保健门诊健康婴幼儿（6～36个月）97例为对照组。采用化学发光免疫法测定各组儿童血清25羟-维生素 D的水平,完成病史采集、查体和实验室检查。结果反复喘息组患儿血清25-羟维生素D平均水平（14.38±4.35）μg/L,低于对照组血清25-羟维生素D平均水平（24.07±11.05）μg/L（F＝33.39,P＜0.001）;反复喘息组血清25-羟维生素D≤20μg/L的发生率90％,而对照组11％,前者明显高于后者（ P＜0.001）;多因素回归分析显示特应性过敏体质、吸烟接触史和血清25-羟维生素D≤20μg/L是婴幼儿反复喘息的危险因素（ OR＝9.89,95％CI 3.15～23.11）。结论婴幼儿反复喘息与血清低水平的25-羟维生素D相关。     

血清维生素D水平与儿童支气管哮喘的相关性及其可能机制

目前儿童支气管哮喘(哮喘)的发病机制尚未完全清楚,临床治疗以控制症状和减少发作次数为主,而不能从一级预防水平干预。哮喘患儿存在血清维生素D水平较低,而纠正维生素D不足或缺乏可作为哮喘辅助治疗方法之一。如果维生素D参与儿童哮喘发病机制,并能作为治疗手段的突破口,将对儿童哮喘治疗进展产生重大影响。现对血清维生素D水平与儿童哮喘的相关性及其可能机制做一综述。     

抽动障碍患儿血清25羟基维生素D水平的检测

目的了解抽动障碍(TD)患儿维生素D的营养状况,探讨维生素D水平与TD的关系。方法选取2016年11月至2017年5月诊断为TD的132例患儿为TD组,其中抽动秽语综合征患儿8例,慢性运动或发声抽动障碍患儿32例,暂时性抽动障碍患儿92例;另选取同期行体检的健康儿童144例为健康对照组。采集两组儿童外周静脉血3 m L,留取血清,采用高效液相色谱-串联质谱法检测两组儿童血清25羟基维生素D[25(OH)D]水平,根据血清25(OH)D水平,30 ng/m L为正常、10~30 ng/m L为不足、10 ng/m L为缺乏。结果 TD患儿血清25(OH)D水平明显低于健康对照组(P0.01);TD患儿血清25(OH)D不足或缺乏率明显高于健康对照组(P0.01);暂时性抽动障碍患儿血清25(OH)D水平高于抽动秽语综合征患儿(P0.05)。结论维生素D缺乏或不足可能是导致TD发病的因素之一;且维生素D水平高低可能与TD分型存在关联。     

25(OH)D免疫功能的研究进展

维生素D不仅具有调节体内钙磷代谢的作用,在体内免疫调节也发挥着重要的作用,与自身免疫性疾病、感染性疾病的发生、发展及干预、转归有密切关系.文章就维生素D与免疫的相关关系及研究进展做一综述.     

儿童急性白血病血清25羟维生素D3的水平及其临床意义

目的：通过检测儿童急性白血病（AL）血清25羟维生素D3的水平,并探讨其临床意义。方法用双抗体夹心酶联免疫吸附试验（ELISA）方法分别测定60例急性白血病患儿,其中30例急性淋巴细胞白血病（ALL）患儿和30例急性髓细胞白血病（AML）患儿在初诊未治前、缓解1个月后、缓解6个月后和对照组30例健康儿童血清25羟维生素D3的水平,并且对其进行比较。结果血清25羟维生素D3的水平：AL初诊未治组（30.95±6.32）nmol／L,AL缓解1个月组（51.32±14.62） nmol／L,AL缓解6个月组（40.13±9.92）nmol／L;ALL初诊未治组（30.51±13.81）nmol／L,ALL缓解1个月组（61.11±18.93）nmol／L,ALL缓解6个月组（44.43±12.60）nmol／L;AML初诊未治组（31.44±7.13）nmol／L,AML缓解1个月组（41.24±10.29）nmol／L,AML缓解6个月组（36.73±9.73）nmol／L;正常对照组（58.71±8.97）nmol／L。方差分析结果：AL、ALL和AML初诊未治疗组的血清25羟维生素D3的水平均明显低于正常对照组（P＜0.05）。AL （初诊未治组、缓解1个月组、缓解6月组）和ALL（初诊未治组、缓解1个月组、缓解6个月组）各组间血清25羟维生素D3的水平差异有显著性（P＜0.05）,AL缓解1个月组和ALL缓解1个月组血清25羟维生素D3的水平与正常对照组差异无显著性;AL和ALL缓解6个月组血清25羟维生素D3的水平低于正常对照组（P＜0.05）。AML三组的血清25羟维生素D3的水平均低于正常对照组（P＜0.05）;ALL与AML初诊未治组血清25羟维生素D3的水平无显著性差异;AL、ALL和AML在化疗过程中血清25羟维生素D3的水平都是先上升,之后又有所下降或者停止上升的趋势。结论动态监测血清25羟维生素D3的水平在儿童急性白血病不同的治疗阶段的变化能够作为判断病情的发展以及评估治疗后效果的一项指标。     

佝偻病维生素D受体基因多态性与25-羟维生素D3相关性

目的：研究1~3岁佝偻病患儿中维生素D受体基因多态性FokⅠ位点与佝偻病相关性,初步探讨维生素D受体基因多态性FokⅠ位点在佝偻病发病中的作用。方法：病例组（佝偻病患儿）62例与对照组（正常健康儿童）60例,用ELISA方法检测血清25-羟维生素D3水平,比较两组之间血清25-羟维生素D3水平。用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）检测病例组和对照组维生素D受体基因多态性FokⅠ位点,比较两组之间基因型和等位基因分布频率。结果病例组血清25-羟维生素D3水平较对照组明显降低,差异有统计学意义（9.1±4.1 ng/mL vs 16.1±6.9 ng/mL;P＜0.05）。维生素D受体基因多态性FokⅠ位点病例组FF基因型明显高于对照组（53% vs 25%）,基因型分布频率差异有统计学意义（χ2=10.221,P＜0.05）,病例组F等位基因频率明显高于对照组（73% vs 57%）,等位基因分布频率差异有统计学意义（χ2=7.511,P＜0.05）。结论维生素D受体基因多态性FokⅠ位点与佝偻病有相关性,提示其在佝偻病遗传易感性方面起重要作用。［中国当代儿科杂志,2010,12（7）：544-546］     

哮喘患儿血清25(OH)D_3水平与血清及支气管肺泡灌洗液中半乳糖凝集素-3水平的关系

目的探讨不同血清25(OH)D_3水平哮喘患儿中血清及支气管肺泡灌洗液(BALF)中半乳糖凝集素-3(Gal-3)水平的变化及临床意义。方法选取2013年1月至2014年12月确诊为哮喘的50例患儿为哮喘组,再根据哮喘患儿血清25(OH)D_3水平不同分为维生素D适当组(n=7)、不足组(n=12)和缺乏组(n=31);另选同期因气道发育畸形或支气管异物住院的20例患儿为对照组。采用ELISA法检测各组患儿血清25(OH)D_3、Gal-3、TIg E及BALF中Gal-3水平。结果哮喘组患儿血清中25(OH)D_3水平较对照组低(P0.05);各组中性粒细胞、嗜酸性粒细胞及上皮细胞计数比较依次为缺乏组不足组适当组对照组(P0.05);哮喘患儿血清25(OH)D_3水平与BALF中中性粒细胞、嗜酸性粒细胞及上皮细胞计数呈负相关(分别r=-0.683、-0.795及-0.670,P0.05);哮喘患儿血清25(OH)D_3水平与血清Gal-3、TIg E水平呈明显负相关(分别r=-0.759、-0.875,P0.05)。结论哮喘患儿普遍存在维生素D缺乏或不足,25(OH)D_3及Gal-3可能参与了哮喘患儿呼吸道炎性反应,与哮喘的发生、发展相关。     

The association between ketoacidosis and 25(OH)-vitamin D levels at presentation in children with type 1 diabetes mellitus

Background:  There is considerable evidence supporting the role of vitamin D deficiency in the pathogenesis of type 1 diabetes mellitus (T1DM). Vitamin D deficiency is also associated with impairment of insulin synthesis and secretion. There have been no formal studies looking at the relationship between 25(OH)-vitamin D₃ and the severity of diabetic ketoacidosis (DKA) in children at presentation with T1DM.
Objective:  To determine the relationship between measured 25(OH)-vitamin D₃ levels and the degree of acidosis in children at diagnosis with T1DM.
Subjects:  Children presenting with new-onset T1DM at a tertiary children's hospital.
Methods:  25(OH)-vitamin D₃ and bicarbonate levels were measured in children at presentation with newly diagnosed T1DM. Those with suboptimal 25(OH)-vitamin D₃ levels (<50 nmol/L) had repeat measurements performed without interim vitamin D supplementation.
Results:  Fourteen of the 64 children had low 25(OH)-vitamin D₃ levels at presentation, and 12 of these had low bicarbonate levels (<18 mmol/L) (p = 0.001). Bicarbonate explained 20% of the variation in vitamin D level at presentation (partial r² = 0.20, p < 0.001) and ethnic background a further 10% (partial r² = 0.10, p = 0.002). The levels of 25(OH)-vitamin D₃ increased in 10 of the 11 children with resolution of the acidosis.
Conclusions:  Acid–base status should be considered when interpreting 25(OH)-vitamin D₃ levels in patients with recently diagnosed T1DM. Acidosis may alter vitamin D metabolism, or alternatively, low vitamin D may contribute to a child's risk of presenting with DKA.     

早产儿和足月儿脐血及母亲静脉血硒含量的比较

目的：硒是一种人体必需的微量元素,在细胞抗氧化防御系统中发挥着主要的作用。在早期早产儿中,低水平的硒会增加诸如慢性新生儿肺疾病、早产儿视网膜病等并发症的发生。该研究旨在检测并比较早产儿和足月儿脐血及母亲静脉血硒含量。方法：选取2008年3~7月间30个足月儿（胎龄>37 周）和30个早产儿（胎龄< 34 周）及他们的母亲作为研究对象。用原子吸收光谱法测定脐血和母亲静脉血的硒含量。结果：足月儿的脐血硒平均含量高于早产儿,差异有非常显著性(124.80± 13.72 μg/L vs 100.30 ± 11.72 μg/L, P=0.0001) 。 足月儿母亲与早产儿母亲的的平均硒含量差异无显著性 (117.03±17.15 μg/L vs 110.56±17.49 μg/L, P=0.15)。将所有婴儿的资料一起分析时,发现脐血硒含量与胎龄和出生体重显著正相关(r=0.66, P<0.0001;r=0.59, P<0.0001)。60例婴儿母亲中,无一例的血硒含量低于正常参考值的下限（70.0 μg/L）。将所有婴儿及其母亲的资料一起分析时,发现母亲血硒含量与其婴儿脐血硒含量呈显著正相关 (r=0.40, P<0.001)。结论：在伊斯法罕地区,孕母的血硒水平处于一个良好的状态,血硒水平不是早产的预测指标。足月儿的脐血硒含量高于早产儿,但足月儿和早产儿的脐血硒含量均在正常参考范围。［中国当代儿科杂志,2009,11（7）：513-516］     

早产儿出生时25羟基维生素D水平与呼吸窘迫综合征关系分析

目的研究早产儿出生时血清25羟基维生素D[25(OH)D]水平与呼吸窘迫综合征(RDS)的关系。方法将2014年1月至2016年12月于新生儿病房住院的符合入组标准和排除标准的早产儿112例分为RDS组(n=72)和对照组(n=40)。收集两组患儿的一般临床资料,包括胎龄、出生体重、性别、分娩方式、1 min及5 min Apgar评分,以及母妊娠期糖尿病和产前激素使用情况。采集患儿的外周静脉血,分离血清,采用化学发光免疫分析法检测血清25(OH)D水平;采用二元logistic回归模型分析25(OH)D水平与RDS发生的关系。结果 RDS组1 min及5 min Apgar评分、血清25(OH)D水平显著低于对照组(P0.05),新生儿窒息及维生素D缺乏发生率显著高于对照组(P0.05)。经二元logistic回归分析结果显示,新生儿窒息(OR=2.633,95%CI:1.139~6.085)、维生素D缺乏(OR=4.064,95%CI:1.625~10.165)是导致早产儿RDS发生的危险因素(P0.05)。结论早产儿出生时维生素D缺乏可能与RDS发病风险增加有关,母孕期合理补充维生素D可能降低早产儿RDS发病率。     

Serum 25 (OH) D and 24,25 (OH)2 D levels in childhood nephrosis under different therapeutic regimens of steroid administration

The effect of prednisone therapy on serum levels of 25-hydroxyvitamin D [25(OH)D] and 24,25-dihydroxyvitamin D [24,25(OH)₂D] was investigated in 16 children with nephrotic syndrome. These serum levels were significantly lower in patients before prednisone therapy than in age- and seasonmatched normal subjects. Patients receiving daily prednisone therapy had lower serum levels than those receiving alternateday prednisone therapy at the time when the total amounts of the steroid administered attained 1,500 or 2,000 mg/m² of body surface area. Daily doses of 40 mg/m² of prednisone for 3 days caused a significant decrease in serum 25(OH)D levels. Withdrawal of the steroid for 4 consecutive days was followed by a significant recovery of the serum levels.These results suggest that alternate-day prednisone therapy rather than daily treatment should be used in clinical practice to help maintain normal vitamin D metabolism.Abbreviations 25(OH)D 25-hydroxyvitamin D - 24,25(OH)₂D 24,25-dihydroxyvitamin D     

The effect of maternal and infant factors on cord blood yield

Umbilical cord blood (CB) can be used as an alternative hematopoietic stem cell source for transplantation in hematological malignancy and blood disorders. The success of transplantation is highly related to the levels of total nucleated cell and CD34⁺ cell counts. The evaluation of optimal conditions can decrease the rate of graft rejection due to low cell count and increases the quality of CB units (CBUs) in the blood bank and the success rate of engraftment. To this end, we review the maternal and infant parameters affecting the quality and quantity of CBUs.     

Serum zinc and copper levels in the maternal blood and cord blood of neonates

Estimation of serum zinc and copper in the maternal blood and cord blood of neonates was carried out to correlate the trace metals in the neonates and their mothers in relation to gestational age and birth weight. Sixty-five healthy neonates, both term and preterm and their mothers were selected. This cross sectional study was done at Azimpur Maternity Centre, Dhaka Medical College Hospital and Chemistry Division, Atomic Energy Centre, Dhaka, Bangladesh from July 1997 to June 1998. The estimation of trace metals was carried out by Atomic Absorption Spectrophotometry (AAS). The mean serum zinc levels in the maternal blood and cord blood were 0.47 ± 0.24 μg/ml and 0.85 ± 0.33 μg/ml respectively and the mean copper levels in the maternal blood and cord blood were 1.37 ± 0.62 μg/ml and 0.31 ± 0.32 μg/ml respectively. Cord blood zinc level was significantly higher and cord blood copper level was significantly lower than the corresponding maternal blood levels. There was no significant correlation between gestational age and serum zinc levels in the cord or maternal blood. But significant inverse correlation was found between gestational age and serum levels of copper in the maternal and cord blood.