25(OH)D_(3)、AKP3联合骨密度检测在儿童佝偻病早期筛查中的价值  

Value of 25(OH)D_(3) and AKP3 combined with bone mineral density detection in early screening of rickets in children

作　　者：康娟[1] 薛小卫 KANG Juan;XUE Xiaowei(Pediatrics Department,the Jintai Hospital of Baoji City,Baoji 721000;Neonatology Department,Baoji People's Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市金台医院儿科,陕西宝鸡721000 [2]宝鸡市人民医院新生儿科,陕西宝鸡721000

出　　处：《临床医学研究与实践》2022年第6期112-115,共4页Clinical Research and Practice

摘　　要：目的分析25-羟维生素D_(3)[25(OH)D_(3)]、碱性磷酸酶-3(AKP3)联合骨密度检测在儿童佝偻病早期筛查中的价值。方法选取2017年9月至2020年3月在我院就诊的600例儿童作为研究对象,其中将104例诊断为佝偻病的患儿设为佝偻病组,其余496例儿童设为正常组。比较两组的血清25(OH)D_(3)、AKP3、血磷、血钙水平、骨密度及25(OH)D_(3)、AKP3和骨密度诊断佝偻病的准确度;分析血清25(OH)D_(3)、AKP3及骨密度单独及联合检测对佝偻病的诊断效能。结果本研究纳入的600例儿童中,确诊佝偻病患儿104例,发病率为17.33%。佝偻病组的血清25(OH)D_(3)、血钙水平及骨密度明显低于正常组,AKP3和血磷水平明显高于正常组,差异具有统计学意义(P<0.05)。血清25(OH)D_(3)诊断佝偻病的准确度为86.00%(516/600),高于AKP3诊断的78.50%(471/600)和骨密度诊断的74.83%(449/600),差异具有统计学意义(P<0.05)。ROC曲线分析显示,血清25(OH)D_(3)、AKP3及骨密度三者联合诊断的ACU均明显大于25(OH)D_(3)、AKP3及骨密度单独诊断,且三者联合诊断的灵敏度、特异度均高于单独诊断(P<0.05)。结论血清25(OH)D_(3)、AKP3及骨密度均可作为儿童佝偻病早期筛查的重要指标,三者联合诊断具有较高的灵敏度、特异度。Objective To analyze the value of 25-hydroxyvitamin D_(3)[25(OH)D_(3)] and alkaline phosphatase-3(AKP3)combined with bone mineral density detection in early screening of rickets in children.Methods A total of 600 children who were treated in our hospital from September 2017 to March 2020 were selected as the research objects,of which104 children diagnosed with rickets were set as rickets group,and the remaining 496 children were set as normal group.The serum 25(OH)D_(3),AKP3,serum phosphorus,serum calcium levels,bone mineral density and the accuracy of 25(OH)D_(3),AKP3 and bone mineral density in the diagnosis of rickets were compared between the two groups;the diagnostic efficacy of serum 25(OH)D_(3),AKP3 and bone mineral density in rickets alone and in combination were analyzed.Results Among the 600 children included in this study,104 were diagnosed with rickets,with an incidence rate of 17.33%.The levels of serum 25(OH)D_(3),serum calcium and bone mineral density in the rickets group were significantly lower than those in the normal group,while the levels of AKP3 and serum phosphorus were significantly higher than those in the normal group,and the differences were statistically significant(P <0.05).The accuracy of serum 25(OH)D_(3) in diagnosing rickets was 86.00%(516/600),which was higher than 78.50%(471/600) in AKP3 and 74.83%(449/600)in bone mineral density,and the differences were statistically significant(P <0.05).ROC curve analysis showed that ACU diagnosed by the combination of serum 25(OH)D_(3),AKP3 and bone mineral density was significantly larger than that of 25(OH)D_(3),AKP3 and bone mineral density alone,and the sensitivity and specificity of the three combined diagnosis were higher than those of alone diagnosis(P <0.05).Conclusion Serum 25(OH)D_(3),AKP3 and bone mineral density can be used as important indicators for early screening of rickets in children,and the combination of the three has a high sensitivity and specificity.

关 键 词：佝偻病 骨密度 25-羟维生素D_(3) 碱性磷酸酶-3 早期筛查 

分 类 号：R722.1[医药卫生—儿科]