佝偻病的临床与实验性诊断相关性的探讨

THE RELATIONSHIP BETWEEN CLINICAL OBSERVATION AND LABORATORY EVALUATION IN VIT D-DEFICIENT RICKETS

近年来小儿佝偻病多以临床诊断为主,但常常可靠性不定,特别在早期轻度佝偻病时。为提高佝偻病临床诊断可靠性,正确认识目前我国小儿佝偻病发病状况,本文研究了佝偻病临床诊断与实验室结果符合情况。结果发现201例临床诊断佝偻病的小儿中经骨X线诊断VitD缺乏性佝偻病15例(7.7％),血生化证实为佝偻病17例(8.7％)。同时经骨X线与血生化检查证实者12例,占临床诊断的6.1％。佝偻病的症状和某些体征的敏感性较低,可作为佝偻病的临床筛查指标,确诊应有骨X线和血生化检查。

Vit D-deficient rickets diagnosis were often based on the clinical manifestations. But the reliability varied, espacially in early stage. to recognize the morbidity of rickets, we investigated the relationship between clinical observation and laboratory evaluations in Vit D-deficient rickets of infants. Our data showed only 15 cases among 201 children, whose diagnoses were based on the clinical criterions, were confirmed by roetgenographic examination. 17 cases were demonstrated by chemical tests. 12 cases were found abnormal changes in both roentgenographic examination and chemical determinations. It suggesged that Vit D - deficient rickets deagnosis should be confirmed by chemical tests and roentgenographic examination. If the diagnosis of rickets were only based on clinical observation. the incidence will be overestimated. The early clinical manifestations and signs should be investigated by advanced techniques in future.