儿童特发性高钙尿症的流行病学和红细胞膜钙泵活性的研究

对青岛市１４１０名健康儿童随意早餐后２ｈ尿钙／肌酐（Ｃａ／Ｃｒ）比值和２４ｈ尿钙定量进行测定。提出以随意早餐后２ｈ尿Ｃａ／Ｃｒ比值≥０．２２，２４ｈ尿钙定量＞０．１ｍｍｏｌ／ｋｇ，作为本地区儿童高钙尿症诊断的标准；据此在本组被调查儿童中检出特发性高钙尿症（ＩＨ）３９例，发病率为２．７７％，无性别差异；钙负荷试验示ＩＨ以肠吸收型为主。同时发现肠吸收型ＩＨ病儿红细胞膜钙泵活性增高，而肾脏漏出型降低，与对照组比较Ｐ＜０．０１或０．０５，推测体内（尤其是小肠和肾小管上皮细胞）钙泵活性异常在ＩＨ发病机制中起重要作用。

THE STUDY ON EPIDEMIOLOGY AND ERYTHROCYTE MEMBRANE CALCIUM PUMP ACTIVITY IN IDIOPATHIC HYPERCALCIURIA IN CHILDREN

We determined the idiopathic hypercalciuria(IH)in 1410 children living in Qingdao District by measuring their urine Ca/Cr ratio 2h after breakfast and making quantitative analysis of calcium excretions within 24 hours after breakfast.The diagnostic creteria were(1)urine Ca/Cr ratio above or equivalent to 0.22 2h after breakfast,(2)urine calcium excretions above 0.1mmol/kg.24h after breakfast, and(3)eliminating secondary hypercalcuria.With these criteria we found 39 out of the 1410 children had IH,the incidence being 2.77%,No differences were found between male and female children.The result of oral loading calcium test showed that the absorptive type in children IH was predominant.In comparison with normal subjects,the erythrocyte membrane calcium pump activity in 24 children with absorptive IH was significantly higher, whereas it was lower in 11 children with renal IH.The results suggest that the pathogenesis of IH is related to the abnormality of the cell membrane calcium pump activity in the intestine and nephron sites.