HPLC-MS/MS法检测吉林省427例儿童血浆25(OH)D的水平

Analysis of the plasma 25(OH) D levels by HPLC-MS/MS method for 427 children in Jilin Province

目的:了解吉林省保健体检儿童血浆25(OH)D的水平,探讨高效液相色谱-串联质谱法(HPLC-MS/MS法)诊断维生素D缺乏性佝偻病的临床意义。方法:采用HPLC-MS/MS法检测并分析了427例体检儿童血浆25(OH)D的水平。结果:①血浆25(OH)D属于正常参考值范围的检出率为41.69%(178/427);低于正常参考值范围的检出率为58.31%(249/427),其中血浆25(OH)D处于缺乏水平的检出率为28.34%(121/427),处于不足水平的检出率为29.98%(128/427);高于正常参考值的检出率为0.00%(0/427)。②255例0～3岁研究对象中,1岁以内婴儿25(OH)D缺乏的发病率为39.34%(24/61),13个月～3岁幼儿25(OH)D缺乏的发病率为15.46%(30/194),二者相比有统计学差异(χ2=15.854 9,P=6.84E-5)。③临床诊断为佝偻病的121例儿童血浆25(OH)D检测结果占全部低于正常参考值儿童的48.59%(121/249),而血浆25(OH)D检测值低于正常参考值但临床尚未诊断佝偻病的儿童占全部低于正常参考值儿童的51.41%(128/249)。结论:①维生素D不足在吉林省的发病率高(58.31%),尤其1岁内婴儿更容易罹患维生素D缺乏,必须进一步加强和规范吉林省佝偻病的防治工作。②目前临床诊断佝偻病与经HPLC-MS/MS法检测25(OH)D诊断佝偻病符合率约50%,应尽快广泛普及此法,提高诊断的敏感性和特异性。

Objective： To understand the plasma 25 （OH） D levels of the children made health examination in Jilin province, to explore the clinical significance of diagnosis of vitamin D deficiency tickets by hyphenated to liquid chromatography systems （ HPLC - MS/ MS） . Methods： To detect and analyze the plasma 25 （OH） D levels of 427 healthy children by HPLC - MS/MS. Results： ①The detec- tion rate of plasma 25 （OH） D in the normal reference range was 41.69% （178/427） ; below normal reference range was 58.31% （249/ 427 ） , including 28.34% （121/427） was in lack level, 29.98% （128/427）was in inadequate level, none was higher than normal refer- ence （0/427） . ②In 255 children aged 0 to 3 year old, the incidence of 25 （OH） D deficiency was 39. 34% （24/61） for the children within 1 year old, 15.46% （30/194） for the children aged 13 months to 3 years old, there was significant difference between the above two groups （X2 = 15. 854 9, P = 6.84E - 5 ） . ③In 249 cases of below normal reference range, the incidence of vitamin D deficiency tickets was 48.59% （121/249） , but another 51.41% （128/249） had not been clinically diagnosed as vitamin D deficiency tickets. Conclusion： ①The incidence rate （58.31% ） of vitamin D insufficiency and lack is high in Jilin province, infants under 1 year old are more likely to suffer from vitamin D deficiency. So we must further strengthen and standardize the prevention and control on tickets in Jilin province. ②For vitamin D deficiency tickets, the coincidence rate of clinical diagnosis and detected 25 （OH） D diagnosis by HPLC - MS/MS method is about 50%, this method should be widely available as soon as possible in order to improve the sensitivity and specificity of diagnosis.