季节、喂养方式及补充钙剂维生素D对婴儿骨强度及骨碱性磷酸酶的影响  

Study on the influence of season,feeding mode,and supplementation of vitamin D and calcium on bone rigidity and bone alkaline phosphatase

作　　者：武玮[1] 赵淑云[1] 李耿[1,2] 马建荣[1] 吴梅 

机构地区：[1]首都医科大学附属北京妇产医院儿科,北京100026 [2]航空总医院儿科,北京100012

出　　处：《临床和实验医学杂志》2017年第12期1218-1222,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的分析季节、喂养方式及补充维生素D、钙剂情况对婴儿骨定量超声测量值及血清骨碱性磷酸酶(BALP)水平的影响,从而为婴儿骨营养的评估提供参考。方法选择0~1岁在北京妇产医院儿科门诊体检的250例健康儿童用标准方法进行胫骨中段定量超声传导速度(SOS)值测定,用免疫渗滤和全血干化学技术方法测定血清BALP活性。比较不同季节、喂养方式及补充钙剂维生素D对婴儿胫骨中段SOS和血清BALP活性的影响。结果于春季接受测量的婴儿胫骨中段SOS为2 912.91±368.10 s/m,夏季为3 040.21±100.71 s/m,秋季为2 952.30±16.23 s/m,冬季为2 892.61±123.36 s/m。夏季显著高于春季和冬季(P<0.01)。人工喂养婴儿胫骨中段SOS为3 011.18±119.01s/m,母乳喂养和混合喂养婴儿分别为2 863.31±338.26 s/m,2 933.25±124.78 s/m,三组之间有显著差异(P<0.01),人工喂养小儿显著高于母乳喂养小儿(P<0.01)。补充钙剂及维生素D婴儿胫骨中段SOS值为2 952.61±252.68 s/m,显著高于未补充婴儿2 850.81±114.61 s/m(P=0.04)。BALP异常检出率在不同季节、不同补充钙剂及维生素D情况及不同喂养方式婴儿中均无显著差异(P>0.05)。结论补充维生素D及钙剂,夏季及人工喂养可提高婴儿骨骼矿化程度。Objective To analyze the influence of season, feeding mode, supplementation of vitamin D and calcium to infants on quanti-tative ultrasound bone measurement and serum level of bone alkaline phosphatase （ BALP） in order to provide the reference for bone nutritional as-sessment in infants. Methods 250 healthy infants （0 -1 years old） from pediatric outpatient clinic of this hospital were selected for this study. Standard methods for determination of value of tibia quantitative ultrasond transmission speed （ SOS） and serum activity of BALP were measured by immunogold filtration and whole blood dry chemical technique. Results The SOS value of infants measured in spring was 2 912. 91 ± 368. 10 s / m, in summer of 3 040. 21 ± 100. 71 s/m, in fall of 2 952. 30 ± 16.23 s/m, and in winter of 2 892. 61 ± 123. 36 s/m. The SOS value in summer was significantly higher than that of both groups in spring and winter （ P 〈 0 .0 1 ） . SOS value in artificial feeding group was 3 011.18 ±119.01 s/m,the values in breast - feeding group and mixed feeding group were 2 863. 31 ± 338. 26 s/m,and 2 933. 25± 124. 78 s/m respectively,these figures in artificial feeding group were significantly higher than those of breast - feeding group （ P 〈 0 .0 1 ） . The tibia SOS value in infants with supplementation of calcium and vitamin D was 2 952. 61 ± 252. 68 s/m,and it was significantly higher than that （2850.81 ±114.61 s/m） of in-fants without supplementation of calcium and vitamin D （ P =0. 0 4 ） . There was no significant difference in anomaly detection rate of BALP in dif-ferent seasons, different feeding modes and ways for supplementation of calcium and vitamin D. Conclusion The supplementation of calcium and vitamin D in summer and artificial feeding can increase the mineral density of bone in infants.

关 键 词：婴儿 骨强度 骨碱性磷酸酶 季节 喂养方式 维生素D 钙剂 

分 类 号：R723.2[医药卫生—儿科]