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目的探讨炎症性肠病(IBD)患儿维生素D水平和骨密度的变化特点。方法选取2014年1月至2014年9月首都医科大学附属北京儿童医院收治的32例IBD患儿为研究对象,同时选取年龄和性别相匹配的30名健康儿童为对照组。收集临床资料包括血钙、血磷、白蛋白,酶联免疫吸附试验检测25-羟维生素D3[25(OH)D3]、骨钙蛋白(BGP)、骨碱性磷酸酶(BALP),定量CT测定骨密度(BMD)。结果 IBD患儿中UC组15例(男9例,女6例),CD组17例(男10例,女7例),对照组30例(男19例,女11例)。IBD组与对照组相比BGP(U=332.5,P=0.444)、BALP(U=350,P=0.637)差异无统计学意义,25(OH)D_3浓度(t=-2.876,P=0.006)、BMD(U=39.5,P<0.05)、血钙(t=-6.654,P<0.05)、血磷(U=216.5,P=0.007)、血清白蛋白(U=25,P<0.05)差异有统计学意义。IBD组中血25(OH)D3浓度与BMD呈正相关(rs=0.504,P=0.005),与血白蛋白水平呈负相关(rs=-0.315,P=0.019)。UC与CD两组间骨密度Z值比较差异无统计学意义(P=0.10)。结论儿童IBD患者普遍存在维生素D不足或缺乏,较健康儿童更易出现骨密度减低。
Objective To investigate the changes of vitamin D levels and bone mineral density in children with inflammatory bowel disease (IBD). Methods Thirty-two IBD children admitted to Beijing Children’s Hospital affiliated to Capital Medical University from January 2014 to September 2014 were selected as the research objects. Thirty healthy children whose age and gender matched were selected as the control group. The clinical data including serum calcium, serum phosphorus and albumin were collected and the levels of 25-hydroxyvitamin D3 [25 (OH) D3], osteocalcin (BGP), bone alkaline phosphatase (BALP) Bone mineral density (BMD) was measured. Results There were 15 UC cases (9 males and 6 females) in IBD group, 17 cases (10 males and 7 females) in CD group and 30 cases in control group (19 males and 11 females). There was no significant difference in BGP (U = 332.5, P = 0.444) and BALP (U = 350, P = 0.637) between IBD group and control group. , Serum calcium (U = 216.5, P = 0.007), serum albumin (U = 25.5, P <0.05) There is statistical significance. The serum concentration of 25 (OH) D3 in IBD group was positively correlated with BMD (rs = 0.504, P = 0.005) and negatively correlated with serum albumin (rs = -0.315, P = 0.019). There was no significant difference in the Z value of BMD between UC and CD (P = 0.10). Conclusion The prevalence of vitamin D deficiency or deficiency in children with IBD is more likely to be lower than that in healthy children.