兰州市榆中县小儿骨关节病与微量元素及相关生物活性物质的临床研究

目的 :探讨微量元素及相关生物活性物质在小儿骨关节病中的作用及其远期效果。方法 :检测 4 0例骨关节病患儿和 30例健康儿童体内 7种血清微量元素、血浆谷胱甘肽过氧化物酶 (GSH -Px)活力 ,丙二醛(MDA)含量及相关临床指标。骨关节病组患儿服用亚硒酸钠 ,1.0mg/d ,连服 1周 ,以后每周 1.0mg ,疗程 6个月。观察治疗前后血清Se,GSH -Px活力、MDA、骨碱性磷酸酶 (BALP)活性、甲状腺激素及免疫球蛋白(IgG、IgA、IgM )等指标 ,随防 1年 ,以观察远期疗效。结果 :治疗后骨关节病组患儿血清Se含量及GSH -Px活力明显增加 (P <0 0 0 1) ,MDA含量显著降低 (P <0 0 1) ,BALP、IgG和IgM恢复正常。完全缓解者 2 4例(6 0 % ) ,明显好转 10例 (2 5 % ) ,总有效率达 85 %。远期疗效较好。结论 :用亚硒酸钠治疗该地区骨关节病患儿 ,提高了缓解率。Se含量减少可能有助于部分阐明该地区小儿骨关节病与缺硒关系的机制。提示临床可适量使用亚硒酸钠。

A clinical study on trace elements and the bioactive substances in children with Kashin - Beck disease in Yuzhong county of Lanzhou

Objective: In order to investigate the functions of trace elements and the bioactive substances in children with Kashin-Beck disease in several regions of Lanzhou and to evaluate the long-term effects of sodium selenite. Method:The trace elements、plasma glutathione pexoxidase(GSH-Px)、plasma malondi- aldehyde(MDA) and the other clinical targets were measured in 40 children with Kashin-Beck disease (KBD) and 30 healthy children.Forty cases of KBD group were treated with sodium selenite at a dose of 1.0mg/day for one week,then a dose of 1.0mg/week for 6 months.Then serum seleniun(Se)、GSH-Px、MDA、BALP、thyroid hormones and serum immunoglobulins(IgG、IgA、IgM) observed before and after treatment.During 1 year of follow-up study,the therapeutic effects in KBD group were being observed. Result:After treatment,Se and GSH-Px levels in KBD group were significantly higher than the patients before treatment (P<0.001),and MDA level of KBD group was decreased obviously (P<0.01).The BALP、IgG and IgM returned to normal level.Complete remission rate was 60%,recurrent rate was 25%.The total effective rate was 85%. Conclusion:After sodium selenite treatment,complete remission rate was enhanced.It is suggested that the reduction of Se may help to explain the partial mechanisms of the relation between lacking Se and KBD.Therefore,it might be suggested that the patients were treated with sodium selenite.