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??Objective To explore features of the change of vitamin D level and bone mineral density in children with inflammatory bowel disease??IBD??. Methods From January 2014 to September 2014??thirty-two children with IBD??study group?? and thirty age and gender-matched healthy children??control group?? were enrolled in the study. The children of study group and control group were tested for bone alkaline phosphate??BALP????bone gla protein??BGP?? and 25??OH??D3 in blood serum by enzyme-linked immunosorbent assay??ELISA????and the clinical data such as calcium??phosphorus and albumin??ALB?? in blood serum were collected. Results There were 15 patients??9 males and 6 females?? with ulcerative colitis??UC?? and 17 patients??10 males and 7 females?? with Crohn’s disease??CD?? in the study group. There were 30 children??19 males and 11 females?? in control group. The level of BGP??U??332.5??P??0.444?? and BALP??U??350??P??0.637?? in blood serum showed no significant difference between the study group and the control group. 25??OH??D3 concentration??t??-2.876??P??0.006????BMD??U??39.5??P??0.05?? ??calcium??t??-6.654??P??0.05????phosphorus??U??216.5??P??0.007????and ALB ??U??25??P??0.05?? showed significant difference between the study group and the control group. In study group??25??OH??D3 concentration and BMD showed positive correlation??rs??0.504??P??0.005????while 25??OH??D3 and blood albumin levels showed negative correlation??rs??-0.315??P??0.019??. There was significant difference betweenUC/CD group and control group in Z score of BMD??U??29.5??P??0.05??U??10??P??0.05????but no statistical difference between UC and CD patients in Z score of BMD ??P??0.10??. Conclusion Most child patients with IBD have insufficient or lack of vitamin D and are more likely to have reduced bone mineral density.     

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??Objective??To assessed serum level of 25??OH??D3 in children with juvenile idiopathic arthritis, in order to find the association between the vitamin D and disease activity as well as bone mineral density. Methods??We evaluated 110 patients??58 females and 52 males??mean age being 9.04±3.37 years?? that fulfilled the 2011 ILAR criteria for juvenile idiopathic arthritis. Patients underwent laboratory tests of serum25??OH??D3??plasma parathyroidhormone and dual-energyx-ray absorptiometry examination. JIA patients were categorized by ACR standard of disease status in 2011??and the disease activity was measured by using JADAS-27. We analyzed the relationship between serum 25??OH??D3 level and other indexes. Results??The mean serum 25??OH??D3 level of 110 JIA patients was??49.8±15.3?? μmol/L. Vitamin D deficiency was detected in 59 patients??53.6%?? and insufficiency in 43 patients??39.1%??. Patients with active disease had significantly reduced serum 25??OH??D3 levels compared to patients with inactive disease??t??5.162??P??0.001????but there was no significant association between serum 25??OH??D3 level and JADAS-27??r??-0.72??P??0.05??. JIA patients with vitamin D deficiency showed a significantly lower bone mineral density than those with normal 25??OH??D3 level??t??3.791??P??0.05??. Patients using glucocorticoid showed significantly lower 25??OH??D3 level than those who never used glucocorticoid??t??2.823??P??0.01??. Conclusion??JIA patients have reduced serum 25??OH??D3??particularly those with active disease or/and using glucocorticoid. JIA patients with vitamin D deficiency showed a significantly lower bone mineral density.     

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目的探讨多层螺旋CT(MSCT)及联合经胸二维超声心动图(TTE)检查在先天性心脏病诊断中的意义。方法收集广东省心血管病研究所自2002年9月至2003年12月间86例儿童先天性心脏病病例,全部患儿接受了MSCT和TTE检查,12例接受心导管检查,其中69例进行了外科手术,将术前MSCT、TTE和心导管检查结果分别与手术诊断进行比较。结果69例患儿共计有129处畸形,TTE正确诊断116处(89.9%),MSCT正确诊断112处畸形(86.8%),两者联合正确诊断127处畸形(98.4%),12例心导管检查未能提供更有价值的资料。结论MSCT对先天性心脏病诊断具有较高的价值,尤其是联合TTE可取代部分心导管检查为外科手术提供正确和充分的术前诊断。对于年龄小或重症不耐受心导管检查的患儿具有更大的意义。     

2416��0~14�꽡����ͯѪ��25-�ǻ�ά����Dˮƽ����

??Objective??To study and analyze the serum 25-hydroxyvitamin D level in children aged from 0 to 14 years old in Shenyang. Methods??A total of 2416 cases of health children were chosen during January 2016 to December 2016. The level of 25??OH??D was determined by high-performance liquid chromatography tandem mass spectrometry. The data were dealt with SPSS19.0. Results??The level of 25??OH??D in 2416 children was??24.63±10.74?? μg/L??in whom the deficiency rate was 18.6%??the insufficiency rate was 16.7%??the sufficiency rate was 64.7%. With the increasing of the age??the level of 25??OH??D had a decreasing tendency. The total abnormal rate of 25??OH??D was 62.5% in??5-year-old group. The serum 25??OH??D level reached the highest in August and September and the lowest in March and April. Conclusion??The nutrition status of 25??OH??D is great in children aged 0 to 5 years old in Shenyang area. However??it is not optimistic in??5-year-old group. Therefore it is necessary to raise the awareness of the nutrition status of 25??OH??D in??5-year-old group. Thus the serum 25-??OH??D level changes significantly with seasons??and should be supplied scientifically and reasonably.     

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维生素D(vitaminD)是大家熟知的脂溶性维生素,维生素D对人类健康特别是儿童健康具有重要意义。维生素D缺乏性佝偻病是由于缺乏维生素D引起体内钙磷代谢异常,钙盐不能正常沉着在骨骼生长部分,骨骼钙化不良而致骨骼病变,多见于婴幼儿,影响小儿生长发育,是我国儿     

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目的研究维生素D受体(VDR)基因BsmI多态性分布,以及与维生素D缺乏性佝偻病的关系,探讨其遗传易感性。方法对象为41例维生素D缺乏性佝偻病患儿和68例健康对照组儿童,均为山西籍汉族儿童,应用聚合酶链反应限制性片段长度多态性分析(PCRRFLP)等技术测定VDR基因BsmI多态性,比较两组基因型和等位基因的分布频率,并用HardyWeinberg遗传平衡检验方法进行基因分布遗传平衡吻合度检验。结果佝偻病患儿组Bb、bb基因型分布频率分别为14.6%和85.4%,健康对照组儿童Bb、bb基因型分布频率分别为19.1%、80.9%。病例组等位基因B、b分布频率分别为7.35%、92.7%,对照组等位基因B、b分布频率分别为9.6%、90.4%,佝偻病组和正常对照组VDR基因型Bb、bb分布频率和等位基因分布频率间没有显著性差异。BsmI多态性分布极不平衡,bb型最多占80.9%,b位点占90.4%,是优势基因。结论VDR基因BsmI酶切位点多态性与维生素D缺乏性佝偻病发病无明显相关性。     

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.     

血清25-羟维生素D在佝偻病诊断中的应用价值

目的：探讨血清25 羟维生素D［25（OH）D］在维生素D缺乏性佝偻病早期诊断中的意义。方法：检测对照组（73例）、可疑组（45例）和佝偻病组（65例）的血清25（OH）D、钙、磷、碱性磷酸酶浓度,并通过ROC曲线对血清25（OH）D的诊断价值进行评价。结果：对照组、可疑组和佝偻病组的血清25（OH）D水平分别为112±37、83±30和72±31 nmol/L,后两者均显著低于对照组（F=26.174,P0.05）。可疑组和佝偻病组的维生素D缺乏率均显著高于对照组（χ2=33.346, P0.05）。结论：血清25(OH)D水平在可疑及确诊佝偻病的患儿中显著降低,可以反映维生素D的营养状况,适用于佝偻病的早期筛查。     

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］     

Unique form of rickets with low serum 25-hydroxyvitamin D in two normally nourished children

We present an unusual type of rickets involving two children: a 2 year old boy and a 15 month old boy, who presented with marked bowing of the lower extremities and bulging of costochondral junctions. Both children had normal growth, with their height and body weight greater than the 50th and 97th percentile for age. Roentgenograms of their extremities showed the typical changes of vitamin D refractory rickets. Serum alkaline phosphatase levels were elevated and serum levels of calcium and phosphate were both within the normal range. No primary cause for the rickets, including nutritional deficiencies, was found in the two patients. Characteristic findings were persistently low serum 25-hydroxyvitamin D (25-OH-D) and normal 1,25-dihydroxyvitamin D (1,25-(OH)2-D). Improvements in clinical and X-ray findings were observed after either oral administration of 1 α-(OH)-D3 (9–15 μg per day) or massive vitamin D2 therapy (600 000 IU single injection). The low serum levels of 25-OH-D did not increase unless massive vitamin D2 therapy was also given. These two cases represent a unique form of rickets that does not meet the criteria for any type of previously known rickets.     

儿童血清25羟维生素D与肥胖及炎症细胞因子关系的研究

目的：探讨儿童血清25羟维生素D [25-(OH)D3]的水平与肥胖及炎症细胞因子的关系,为临床评估维生素D营养状况与肥胖症的关系提供依据。方法：以2012年2~6月就诊的78例肥胖症儿童为研究对象,并根据年龄、性别等基线情况选取同期进行健康体检的105名儿童作为对照组。抽取空腹静脉血测定血清25-(OH)D3、IL-6、IL-8、IFN-γ、TNF-α。结果：肥胖组儿童25-(OH)D3明显低于对照组（P<0.01）。25-(OH)D3水平与BMI Z-Score呈负相关（r=-0.462,P<0.01）。按血清25-(OH)D3水平将患儿分为维生素D充足组、不足组、缺乏组及严重缺乏组,各亚组间血清IFN-γ水平差异有统计学意义（P<0.05）,而血清IL-6、IL-8、TNF-α水平差异无统计学意义。结论：肥胖儿童较正常儿童25羟维生素D水平低;血清维生素D水平与BMI有相关性,但与炎症细胞因子相关性不大。     

学龄前儿童血清25羟维生素D调查分析

目的 调查5月份苏州地区部分学龄前儿童血清25羟维生素D［25（OH）D］水平,为儿童摄入及补充维生素D提供依据。方法 2012年5月选取苏州城区及郊区来苏州大学附属儿童医院体检的学龄前儿童852名为研究对象, 年龄3～7岁, 其中男454名、 女398名。分为3～4岁、 ＞4～5岁、 ＞5～6岁和＞6～7岁4组。测定身高和体重, 以体重指数（BMI）评价儿童体型分为超重与非超重组, 肥胖与非肥胖组。采用ELISA法测定所有研究对象血清25（OH）D水平。结果 3～4岁血清25（OH）D高于＞4～5岁、 ＞5～6岁、 ＞6～7岁3组, 差异有统计学意义（χ2依次为110.43、 216.54和198.18, P均＜0.05）; ＞4～5岁血清25（OH）D高于＞5～6岁、＞6～7岁两组, 差异有统计学意义（χ2分别为106.11和87.75, P均＜0.05）。361例（42.37%）存在血清25（OH）D缺乏, 344例（40.38%）存在血清25（OH）D不足。不同性别间血清25（OH）D差异无统计学意义（χ2 = 1.23, P＞0.05）。超重与非超重儿童血清 25（OH）D 分布分别为 53.97（45.27～66.45） nmol/L和52.64 （42.85～63.80） nmol/L; 而肥胖与非肥胖儿童分别为55.24（47.29～66.56） nmol/L和 52.71（43.11～63.92） nmol/L,组间血清25（OH）D分布差异均有统计学意义（χ2分别为7.10和6.73,P均＜0.05）。血清25 （OH）D与 BMI 呈正相关 （r = 0.11,P＜0.05）。结论 所调查苏州地区部分学龄前儿童血清 25（OH）D 总体不足。儿童血清25（OH）D与BMI呈正相关。应加强血清25（OH）D监测,并采取科学措施加强学龄前儿童维生素D摄入及补充。     

石家庄市夏季汉族4月龄至14岁健康儿童血清25-羟维生素D和甲状旁腺素的关系

目的探讨汉族儿童青少年夏季血清25-羟维生素D(25OHD)和甲状旁腺素(PTH)水平的关系,以及儿童青少年是否存在PTH进入平台期的血清25OHD拐点值。方法河北医科大学第二医院儿科生长发育门诊于2011年6~8月及2012年6~8月向社会招募4月龄至14岁健康儿童青少年。分为1岁、~3岁、~6岁、~10岁和~14岁组。分别采用酶联免疫法和化学发光免疫分析法测定血清25OHD和全段PTH水平。对血清25OHD与PTH水平的关系分别行直线、二次多项式、指数和对数拟合等,计算血清PTH水平进入平台期的血清25OHD阈值。结果共招募632名健康儿童青少年,男童372名,女童260名。1血清25OHD和PTH水平的中位数(P25,P75)分别为56.7(42.2,76.4)nmol·L-1和2.5(2.0,3.3)pmol·L-1。2血清25OHD与PTH在除~10岁组外的其余年龄组中均呈负相关。3二次多项式回归方程能较好反映血清25OHD和PTH之间的曲线关系。回归方程为PTH(pmol·L-1)=4.2698-0.0352·25OHD+0.0002·25OHD2,R2=0.0684。PTH进入平台期时血清25OHD的拐点值为88 nmol·L-1,对应的PTH值为2.72 pmol·L-1。结论 4月龄至14岁汉族儿童青少年的血清25OHD和PTH水平呈负相关,且理想的血清25OHD水平可能为88 nmol·L-1。     

The association of serum 25-hydroxyvitamin D3 and D2 with depressive symptoms in childhood--a prospective cohort study

Background: Depression in adolescence is common and early onset predicts worse outcome in adulthood. Studies in adults have suggested a link between higher total 25‐hydroxyvitamin D [25(OH)D] concentrations and lower risk of depression. Objectives: To investigate (a) the association between serum 25(OH)D₂ and 25(OH)D₃ concentrations and depressive symptoms in children, and (b) whether the associations of 25(OH)D₂ and 25(OH)D₃ are different from, and independent of, each other. Methods: Prospective cohort study with serum 25(OH)D₂ and 25(OH)D₃ concentrations measured at mean age of 9.8 years and depressive symptoms assessed with the Mood and Feelings Questionnaire by a trained interviewer at the mean ages of 10.6 years (n = 2,759) and 13.8 years (n = 2,752). Results: Higher concentrations of 25(OH)D₃ assessed at mean age 9.8 years were associated with lower levels of depressive symptoms at age 13.8 years [adjusted risk ratio (RR; 95% confidence interval (CI)): 0.90 (0.86–0.95)], but not at age 10.6 years [adjusted RR (95% CI): 0.98 (0.93–1.03)] and with increased odds of decreasing symptoms between age 10.6 and 13.8 years [adjusted RR (95% CI): 1.08 (1.01–1.16)]. Serum 25(OH)D₂ concentrations were not associated with depressive symptoms. Conclusions: This is the first study in children to suggest that the association between 25(OH)D₃ concentrations and depression emerges in childhood. The association is independent of a wide range of potential confounding factors, and appears to be stronger with greater time separation between assessment of 25(OH)D₃ and assessment of depressive symptoms. Confirmation of our findings in large prospective studies and trials would be valuable.     

0~7岁儿童25羟维生素D和骨密度的关系研究

目的 评价 0~7 岁儿童维生素 D（VitD）营养状况及与骨密度的关系。方法 选择生长发育门诊因“生长发育缓慢、夜惊、多汗、烦躁不安”等就诊的儿童 6 838 人,采用化学发光法法测定血清 25 羟VitD [25-（OH）D] 水平,并同时应用定量超声仪进行骨密度检测。结果 研究对象血清 25-（OH）D 的水平为34±14 ng/mL,定量超声骨密度 Z 值为 -0.49±0.54。随着年龄增长,25-（OH）D 和骨密度水平逐渐降低,且 VitD缺乏、不足及骨密度不足的检出率逐渐增加（PPP结论 学龄前期和学龄期儿童 VitD 不足和缺乏的现象较婴幼儿更严重。在一定范围内 VitD 水平和骨密度可能有关。