婴儿发育性髋关节发育不良与骨密度和维生素D的相关性研究  

Correlation between developmental dysplasia of the hip with bone mineral density and vitamin D in infants

作　　者：石影 杨茜 张永花[1] 郑华 张婧洁[1] 刘艳敏[1] Shi Ying;Yang Qian;Zhang Yonghua;Zheng hua;Zhang Jingjie;Liu Yanmin(Department of Child Health Care,Lanzhou Maternal and Child Health Care Hospital,Lanzhou 730030,China;Department of Ultrasound,Lanzhou Maternal and Child Health Care Hospital,Lanzhou 730030,China)

机构地区：[1]兰州市妇幼保健院儿童保健科,甘肃兰州730030 [2]兰州市妇幼保健院超声科,甘肃兰州730030

出　　处：《兰州大学学报（医学版）》2024年第9期35-39,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：兰州市科技计划资助项目(2021-1-123);兰州市科技计划资助项目(2022-2-108);兰州市卫生健康行业科研资助项目(A2023024)。

摘　　要：目的探究钙和维生素D缺乏对婴儿髋关节发育情况有无影响,以提高孕产妇及家庭对发育性髋关节发育不良(DDH)的正确认识,降低DDH的发病率,提高人口素质。方法对2021年3月—2023年3月对兰州市妇幼保健院儿童保健科体检的1107名3月龄婴儿,先进行临床检查,记录髋关节的发育状况、外部形态及运动状态,然后行超声检查,采用Graf法测量评估髋关节发育状况。同时检测婴儿骨密度相关参数、骨碱性磷酸酶和25-羟基维生素D[25-(OH)-D]的含量,采用相关分析和多因素Logistic回归分析探究婴儿骨密度和维生素D水平对髋关节发育情况有无影响。结果1107例受检婴儿中,髋关节发育正常990例,存在单侧或双侧髋关节发育不良117例,DDH检出率为10.6%;DDH组左侧和右侧α角均小于正常组,差异有统计学意义(P<0.05);2组间左侧和右侧β角之间的差异均无统计学意义(P>0.05);两侧α角、β角与骨密度、超声传导速度、z值和25-(OH)-D均无线性相关关系(P>0.05);DDH组骨密度、超声传导速度、z值和25-(OH)-D均低于正常组,差异有统计学意义(P<0.05);增加骨密度和25-(OH)-D含量为DDH发病的保护因素。结论婴儿期适当补充钙和维生素D有助于降低DDH的发病率。Objective To investigate whether calcium and vitamin D deficiency in infants have any effect on hip development,in order to further the correct understanding of developmental dysplasia of the hip(DDH)among maternity women and their families,reduce the incidence of DDH and improve population quality.Methods 1107 infants aged 3 months who underwent physical examination at the Child Health Department of Lanzhou Maternal and Child Health Hospital between March 2021 and March 2023 were first clinically examined to record the external morphology,development and movement status of the hip joint,then ultrasonographically,and hip development was assessed by the Graf method.The infants'bone mineral density elated parameters,bone alkaline phosphatase and 25-hydroxyvitamin D[25-(OH)-D]levels were also measured to investigate whether the infants'bone mineral density and vitamin D content had any effect on the development of the hip joint via correlation analysis and multifactor logistic regression analysis.Results Among 1107 infants examined,there were 990 cases of normal hip development and 117 of unilateral or bilateral hipdysplasia,and the detection rate of DDH was 10.6%;the left and rightαangles of the DDH group were smaller than those of the normal group,and the differences were statistically significant(P<0.05);differences between the left and rightβangles between the two groups were not statistically significant(P>0.05);There was no linear correlation between bilateralα-angle andβ-angle and bone mineral density,speed of ultrasound(SOS),z-value and 25-(OH)-D(P>0.05);bone mineral density,speed of ultrasound,z-value and 25-(OH)-D were lower in the DDH group than in the normal group,and the difference was statistically significant(P<0.05);increased bone mineral density and 25-(OH)-D were protective factors for the development of DDH.Conclusion Supplementation with appropriate calcium and vitamin D in infancy can help reduce the incidence of DDH.

关 键 词：发育性髋关节发育不良 骨密度 25-羟基维生素D 超声传导速度 

分 类 号：R17[医药卫生—妇幼卫生保健]