儿童骨代谢标志物  

Bone metabolism markers in children

作　　者：崔坤华 李琪[1] 

机构地区：[1]昆明医科大学第一附属医院儿科,云南昆明650032

出　　处：《中国骨质疏松杂志》2017年第11期1523-1529,共7页Chinese Journal of Osteoporosis

基　　金：云南省应用基础计划项目(昆明医科大学联合专项)基金资助项目(AFRP2014)

摘　　要：儿童骨骼处于生长发育阶段,不同年龄阶段骨骼的生长存在不均衡性,且容易受疾病、外界环境、药物等诸多因素的影响,所以建立儿童特异的骨代谢标志物十分重要。骨代谢的检测方法很多,传统的双能X线吸收测定法辐射剂量低,精度及准确度高,且为无创性而被广泛应用于儿童骨骼系统疾病的检测,但其测定的骨密度反映的是一段时间内骨骼的静态状况,不能反映骨组织的动态本质,不能早期反映骨量的丢失,易导致骨质疏松的漏诊及误诊。而骨代谢标志物能反映骨代谢转换的动态情况,能反映骨代谢的早期灵敏变化,其测量可以早期评估骨代谢性疾病及监测治疗效果,联合骨密度检测能更准确地评估骨量的丢失,减少骨质疏松的漏诊及误诊。本文综述儿童骨代谢标志物特点及其意义,儿童参考范围、临床应用及影响因素等。以期早期发现儿童骨量的变化,对儿童骨骼系统疾病做到早发现、早诊断、早治疗,提高患儿骨骼系统疾病的近期及远期预后,进而提高儿童的生活质量。The bone is growing and developing in children.The bone growth is not balanced in different age and is vulnerable to disease,the influence of the external environment,drugs,and many other factors.Therefore,it is very important to establish specific bone metabolism markers in children.There are many method to detect bone metabolism markers.Traditional dual-energy X-ray absorptiometry is in low radiation dose,noninvasive,and with high precision and accuracy.It has been widely used in detecting the systemic skeletal diseases in children.However,the detected bone mineral density is in static condition of bone at a certain period of time.It does not reflect to the dynamic nature of bone tissue and the loss of bone mass at the early stage.It may lead to missed diagnosis or misdiagnosis of osteoporosis.Bone metabolism biomarkers can reflect the dynamic condition of bone turnover with high sensitivity in its early stage.It can assess the bone metabolic disease earlier,monitor the efficacy of treatment,accurately assess bone loss combining with bone mineral density detection,and reduce missed diagnosis and misdiagnosis of osteoporosis.This review describes the characteristics and meaning of bone metabolism biomarkers and the reference ranges of children,the clinical practice,and the influence factors.The aim is to detect the change of bone mass as early as possible,hoping that we can detect,diagnose,treat diseases on skeletal system in children early,and improve the immediate and long-term prognosis of the skeletal system disease in children,and then improve children＇s life quality.

关 键 词：儿童 骨代谢标志物 骨代谢 骨质疏松 

分 类 号：R725.8[医药卫生—儿科]