膝关节夜间痛患儿相关骨代谢指标及阿法D3的干预效应(英文)  

Interventional effects of alpha D3 on related bone metabolism indexes of children with knee pain at night

作　　者：潘志宏 张康乐[2] 刘德昌[2] 蔡国平[2] 

机构地区：[1]上海浦东新区杨思医院骨科,上海市200126 [2]上海复旦大学附属金山医院骨科,上海市200540

出　　处：《中国临床康复》2006年第32期178-180,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:临床上常见3～15岁少儿不明原因的膝关节夜间痛,且反复发作。大多数称之为“生长痛”。目的:分析少儿膝关节夜间痛的相关因素,观察阿法D3的干预效应。设计:病例-对照分析,自身前后对照分析。单位:上海复旦大学附属金山医院骨科。对象:选择1998-06/2002-08在上海复旦大学附属金山医院门诊治疗的反复发作的不明原因膝关节夜间痛患儿22例,为膝关节夜间痛组,年龄3～15岁。以同期创伤骨折愈合半年之后的患儿20例为对照组。方法:对膝关节夜间痛组患儿采用骨矿化剂阿法D30.25μg口服,1次/d,连续1周,停药观察3周,4周为1个疗程。如仍有夜间痛或酸痛停止后又出现者,再继续1个疗程,直至夜间痛消失。测定常有膝关节夜间痛组与对照组患儿的骨钙素、血钙、磷、镁及碱性磷酸酶和骨密度,并观察膝关节夜间痛组采用阿法D3治疗前和治疗后1,3,6个月骨钙素的指标和夜间膝痛的变化。1个疗程结束后,复查血钙、磷、镁、碱性磷酸酶、骨钙素、降钙素、尿常规和膝关节X射线平片,6个月复查骨密度。主要观察指标:①膝关节夜间痛患儿治疗前后检测血钙、磷、镁、血碱性磷酸酶。②膝关节夜间痛患儿治疗前和治疗后1,3,6个月骨钙素水平,治疗前和治疗后6个月查骨密度;对照组在骨折愈合后6个月和1年时查上述指标。③阿法D3治疗的疗效。结果:42例全部进入结果分析。①膝关节夜间痛患儿治疗前后检测血钙、磷、镁、血碱性磷酸酶均正常。②对照组患儿骨折愈合后1年骨钙素明显低于骨折愈合后6个月[(7.06±0.74),(7.44±1.16)μg/L,P<0.01];膝关节夜间痛组患儿治疗前为15.98μg/L,显著高于对照组,治疗后1,3,6个月分别为(12.12±2.2),(10.6±81.31),(7.60±0.95)μg/L,治疗前后比较差异显著(P<0.05)。③两组患儿骨密度比较差异无显著性意义(P>0.05)。④膝夜间酸痛夜间疼痛在采用阿法D3治�BACKGROUND： It is often seen in clinical practice that children, aged 3-15 years, suffer from knee pain of unknown cause at night, which occurs frequently. Most of them can be called ＂pain of growth＂. OBJECTIVE： To analyze the related factors of knee pain in adolescents and observe the interventional effect of alpha-D3 （α-D3）. DESIGN： Case control analysis, self-control analysis. SETTING： Department of Orthopaedics, Jinshan Hospital Affiliated to Shanghai Fudan University PARTICIPANTS： We admitted 22 children outpatients, aged 3 to 15 years, who suffered from recurrent attack of knee pain of unknown reasons and received treatment in Jinshan Hospital Afflhated to Shanghai Fudan University from June 1998 to August 2002, serving as group A. Another 20 children outpatients of fracture recovered for half a year were recruited stultaneously, serving as Group B （control group）. METHODS： Group A adopted the therapy of orD3 of 0.25 μg taken orally once everyday for successive 7 days then stopped to observe the symptoms for the next three weeks. Four weeks was one therapeutic course. If the pains were still alive or reoccurred, another therapy period was needed until they vanished. The contents of bone gla protein （BGP）, blood calcium （Ca^2＋）, blood phosphorus （p^3＋）, blood magnesium （Mg^2＋）, alkaline phosphatase ＂（ALP） and bone mineral density （BMD） of patients were detected between Group A and Group B. GBP index and change of pain in knee at night was observed with α-D3 before therapy and 1,3 and 6 months after therapy. After one therapy period, the levels of blood Ca^2＋, P^3＋, Mg^2＋, ALP, BGP, CT, urine and X-ray of knees were detected again, so was BMD after 6 months. MAIN OUTCOME MEASURES： ① Blood Ca^2＋, p^3＋, Mg^2＋, ALP contents of children patients were detected before and after therapy . ②In the Group A, content of BGP was detected before and 1,3 and 6 months after therapy , and BMD before and 6 months after therapy ; The above in

关 键 词：儿童 膝关节 骨钙素 胆骨化醇 

分 类 号：R332.72[医药卫生—人体生理学]