骨密度检测对婴幼儿佝偻病早期诊断的临床意义  

Clinical Significance of Bone Mineral Density Measurement for the Early Diagnosis of Infant Rickets

作　　者：吕晓倩 刘娜[1] 殷站茹[1] 郭靖[1] 张文浩 LV Xiao-qian;LIU Na;YIN Zhan-ru;GUO Jing;ZHANG Wen-hao(Harrison International Peace Hospital(Hengshui people's Hospital of Hebei Province),pediatric internal medicine,Hengshui,Hebei,053000,China;The fourth hospital of Hebei Medical University,pediatrics,Shijiazhuang,Hebei,050011,China)

机构地区：[1]哈励逊国际和平医院(河北省衡水市人民医院)小儿内科,河北衡水053000 [2]河北医科大学第四医院儿科,河北石家庄050011

出　　处：《现代生物医学进展》2020年第13期2589-2592,共4页Progress in Modern Biomedicine

基　　金：河北省医学科学研究重点课题计划项目(20180614);衡水市科学支撑计划项目(2017014046Z)。

摘　　要：目的:探讨骨密度检测在佝偻病早期诊断中的应用价值。方法:收集衡水市哈励逊国际和平医院门诊诊治的600例婴幼儿,以血清维生素D3<27.5 nmol/L为判定标准分为非佝偻病组和佝偻病组,比较两组婴幼儿维生素D3、骨碱性磷酸酶和骨密度,绘制维生素D3、骨碱性磷酸酶、骨密度诊断结果的ROC曲线图,对骨密度检测结果进行评价。结果:佝偻病组婴幼儿维生素D3和骨密度Z值明显低于非佝偻病组,骨碱性磷酸酶显著高于非佝偻病组(P<0.05)。维生素D3诊断佝偻病的ROC曲线下面积为0.951,灵敏度为0.973,特异度为0.840;骨碱性磷酸酶诊断佝偻病的ROC曲线下面积为0.866,灵敏度为0.824,特异度为0.747;骨密度Z值诊断佝偻病的ROC曲线下面积为0.923,灵敏度为0.826,特异度为0.875,骨密度指标诊断佝偻病的曲线下面积和维生素D3比较无统计学意义(P>0.05),但骨密度指标诊断佝偻病的曲线下面积大于骨碱性磷酸酶(P<0.05)。结论:超声骨密度检测在婴幼儿佝偻病早期诊断中具有一定价值,其诊断敏感性、特异性、准确率与维生素D3诊断基本相当,且骨密度检测存在无创、可重复性高等优点。Objective:To explore the application value of bone mineral density test in early diagnosis of rickets.Methods:600 infants and young children diagnosed and treated in the outpatient department of Harrison International Peace Hospital in Hengshui City were collected and divided into non-rickets group and rickets group with serum vitamin D3<27.5 nmol/L as the criterion.vitamin D3,bone alkaline phosphatase and bone mineral density of the infants and young children in the two groups were compared,ROC curves of diagnosis results of vitamin D3,bone alkaline phosphatase and bone mineral density were drawn,and the bone mineral density test results were evaluated.Results:Vitamin D 3 and bone mineral density Z values of infants in rickets group were significantly lower than those in non-rickets group,and bone alkaline phosphatase was significantly higher than that in non-rickets group(P<0.05).The area under ROC curve of vitamin D3 in the diagnosis of rickets was 0.951,the sensitivity was 0.973,and the specificity was 0.840.The area under ROC curve of bone alkaline phosphatase in the diagnosis of rickets was 0.866,the sensitivity was 0.824,and the specificity was 0.747.The area under ROC curve for diagnosing rickets with bone density Z value was 0.923,the sensitivity was 0.826,and the specificity was 0.875.There is no statistical significance between the area under curve for diagnosing rickets with bone density index and vitamin D3(P>0.05),but the area under the curve of bone mineral density index in diagnosis of rickets was larger than that of bone alkaline phosphatase(P<0.05).Conclusion:Ultrasonic bone density detection has certain value in the early diagnosis of infantile rickets.Its diagnostic sensitivity,specificity and accuracy are equal to vitamin D3 and bone density detection with the advantages of non-invasive and high repeatability.

关 键 词：佝偻病 维生素D3 骨碱性磷酸酶 骨密度 

分 类 号：R723.2[医药卫生—儿科]