先天性心脏病患儿骨强度状况及影响因素分析  

Bone mineral density, of children with congenital heart disease and analysis on its influence factors

作　　者：龚春丹[1] 孙锟[2] 杜青[1] 周璇[1] 陈笋[2] 杨玲[2] 王鉴[2] 梁菊萍[1] 杨晓颜[1] 陈楠[1] 邓巍巍[1] 夏英华[2] 徐毅超 

机构地区：[1]上海交通大学医学院附属新华医院康复医学科,上海市小儿外科临床医学中心,200092 [2]上海交通大学医学院附属新华医院小儿心血管科,200092

出　　处：《中华实用儿科临床杂志》2017年第1期47-49,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：上海市卫生计生系统重要薄弱学科（康复医学）建设项目（2015ZB0406）;上海交通大学医学院附属新华医院院基金（13YJ27,15QT17）

摘　　要：目的探讨先天性心脏病（CHD）患儿骨强度状况并分析相关影响因素。方法对2013年10月至2015年1月就诊于上海交通大学医学院附属新华医院小儿心血管科确诊为CHD且无心外科手术指征的患儿以定量超声方法检测左侧胫骨中段的骨骼超声波传播速度（SOS）值获得骨强度，与亚洲儿童数据库比较获得Z值，评价骨强度健康程度。对照组为同期上海幼儿园年龄、性别匹配的健康儿童。结果CHD组120例，男49例，女71例；年龄（52.43±25.60）个月；体质量（17.72±6.69） kg；身高（105.38±14.55） cm。对照组109例，男55例，女54例；年龄（53.25±13.08）个月；体质量（18.36±3.65） kg；身高（105.81±14.69） cm。2组间性别、年龄、身高、体质量比较差异均无统计学意义（均P〉0.05）。CHD类型前3位为室间隔缺损（51例）、房间隔缺损（30例）和动脉导管未闭（16例）。CHD组患儿骨强度未达正常55例（45.8%），其中严重骨强度不足12例（10.0%），中度骨强度不足6例（5.0%），轻度骨强度不足10例（8.3%），骨强度偏低27例（22.5%）；骨强度正常65例（54.2%）。CHD组SOS值为（3 515.00±186.32） m/s，与对照组[（3 532.07±132.73） m/s]比较，差异无统计学意义（t＝0.804，P〉0.05）。CHD患儿SOS值与身高（r＝0.338，P〈0.001）、体质量（r＝0.299，P＝0.001）呈正相关，与年龄、性别无相关性（P〉0.05）。结论CHD患儿骨强度与健康儿童相近，但仍有近50%患儿未达健康状态，需引起临床医师及家长重视。开展相关康复训练及家长指导和宣教，为成年期骨骼健康奠定良好的基础。Objective To investigate the epidemiology and risk factors for the bone mineral density （BMD） of children with congenital heart disease （CHD）. Methods CHD children without cardic surgery indication were taken as CHD group who were admitted to the Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiaotong Univer- sity School of Medicine from October 2013 to January 2015. Age - sex - matched healthy children from a kindergarten in Shanghai were enrolled as controls. Anthropometric measurement by quantitative ultrasound was utilized to detect bone speed of sound （SOS）. SOS were compared to Asian children＇s criterion, and Z score was calculated for statistical analyses. Results One hundred and twenty children with CHD were included,among whom 49 were boys and 71 were girls with mean age （52.43 ± 25.60 ） months, mean body weight （ 17.72± 6.69 ） kg and mean height （ 105.38 ± 14. 55） cm. The control group included 109 children with 55 boys and 54 girls,mean age （53.25 ±13.08） months, mean body weight （ 18.36 ±3.65 ） kg and mean height （ 105.81 ± 14.69 ） cm. There was no statistical difference in age,sex,body height and body weight between the CHD group and the control group（ all P 〉 0.05）. Ventricular septal defect （51 cases）, atrial septal defect（ 30 cases） and patent ductus arteriosus （16 cases） were the most popular CHD types. There were 55（45.8% ） children who had no healthy BMD,among whom 12 （ 10.0% ） patients had severe BMD deficiency,6 （5.0%） patients with moderate BMD deficiency, 10 （8.3%） patients with mild BMD deficiency, and 27 （22.5%） patients with low BMD. Sixty - five （54.2%） children had healthy BMD in CHD group. There was no statistical difference in SOS between CHD group[ （3 515. 00 _± 186.32） m/s] and the control group [ （3 532.07 ±132.73） m/s] （ t = 0. 804, P 〉 0.05 ）. SOS was positively associated with height （ r = 0. 338, P 〈 0. 001 ） and weight （ r = 0. 299, P = 0. 001 ）, but

关 键 词：先天性心脏病 超声骨强度 儿童 

分 类 号：R725.4[医药卫生—儿科]