血清骨代谢生化指标对儿童维生素D缺乏性佝偻病的诊断价值探讨  

Study on diagnostic value of bone metoblic biochemical indicators in children with vitamin D deficiency rickets

作　　者：夏永杰[1] 韩镜明[1] 游超[1] 吴德超[1] 王建胜[1] 刘志勇 谢良富 邓超 夏安宁 刘博 周益彪 XIA Yongjie;HAN Jingming;YOU Chao;WU Dechao;WANG Jiansheng;LIU Zhiyong;XIE Liangfu;DENG Chao;XIA Anning;LIU Bo;ZHOU Yibiao(Second Department of Orthopedics,Shenzhen Municipal Children′s Hospital,Shenzhen,Guangdong 518026,China)

机构地区：[1]广东省深圳市儿童医院骨二科,518026

出　　处：《重庆医学》2020年第20期3392-3394,3398,共4页Chongqing medicine

基　　金：深圳市卫生计生系统非资助科研项目(SZFZ2017008)。

摘　　要：目的探讨血清总Ⅰ型胶原氨基端延长肽(TPINP)和β-胶原降解产物(β-CTx)对儿童维生素D缺乏性佝偻病的诊断价值。方法以该院骨科2017年10月至2019年6月就诊的2214例疑似维生素D缺乏性佝偻病的患儿为研究对象,取静脉血分别测定血清25羟维生素D[25-(OH)D]与TPINP和β-CTx。结果以血清25-(OH)D<30 ng/mL为维生素D缺乏的标准,TPINP<49.9 ng/mL时,特异度为99.9%,灵敏度仅为0.8%,而β-CTx>1.83 ng/mL时,特异度为91.6%,灵敏度为28.1%;两者的阳性似然比均小于10,阴性似然比均大于0.1。结论TPINP和β-CTx不适用于维生素D缺乏性佝偻病的诊断,但可作为排除佝偻病的参考指标。Objective To explore the diagnostic value of serum total N-terminal propeptide of typeⅠprocollagen(TPINP)andβ-collagen specific sequences(β-CTx)in children with vitamin D deficiency rickets.Methods A total of 2214 children with suspicious vitamin D deficiency rickets in the orthopedic department of this hospital from October 2017 to June 2019 served as the study subjects.The venous blood samples were collected to detect serum 25 hydroxy vitamin D[25-(OH)D],TPINP andβ-CTx.Results With serum 25-(OH)D<30 ng/mL as the criterion of vitamin D deficiency,when the TPINP level<49.9 ng/mL,the specificity was 99.9%,but the sensitivity was only 0.8%;and when theβ-CTx level>1.86 ng/mL,the specificity was 91.6%,but the sensitivity was only 28.1%;the positive likelihood ratio of both was less than 10,and the negative likelihood ratio was more than 0.1.Conclusion TPINP andβ-CTx are not suitable for the diagnosis of vitamin D deficiency riskets,but can be used as a reference index to exclude rickets.

关 键 词：维生素D缺乏性佝偻病 25羟维生素D 总Ⅰ型胶原氨基端延长肽 β-胶原降解产物 儿童 

分 类 号：R726.8[医药卫生—儿科]