全血钙和骨碱性磷酸酶检测在佝偻病诊断中的应用

Value of detection of calcium in whole blood and bone alkaline phosphatase in the diagnosis of rickets.

目的探讨全血钙和骨碱性磷酸酶（BALP）在儿童维生素D缺乏性佝偻病中的诊断价值。方法对755例体检儿童采末梢血，用全血干化学法和免疫浓缩技术检测BALP，全血钙检测采用原子吸收光谱分析法。结果755例体检儿童中BALP≤200U／L138例，200-250U／L386例，≥250U／L231例。血钙〈1．55mmol／L79例，≥1．55mmol／L676例。BALP异常检出率为81．7％（617／755），血钙异常检出率为10．5％（79／755）。血钙在各年龄组和男女性别间差异均无统计学意义。BALP在男女性别间差异无统计学意义，在不同年龄组间差异有统计学意义，1岁以下组BALP异常检出率最高，3-5岁组最低。大部分儿童处于维生素D轻度缺乏或缺乏状态，且随着年龄增长发病率有逐渐降低的趋势。结论BALP的检测在维生素D缺乏性佝偻病诊断中较血钙测定敏感，更能反映人体钙营养水平。为更好地预防、控制和治疗佝偻病，婴幼儿应定期做相关项目的健康体检。

Objective To investigate the diagnostic value of calcium in whole blood and bone alkaline phos-phatase （BALP） in vitamin D deficiency rickets in children. Methods Peripheral blood was collected from 755 chil-dren. Levels of BALP were detected based on dry chemical and immune concentrated technique, and calcium was detect-ed by atomic absorption spectroscopy. Results BALP levels were showed ≤200 U/L in 138 children, 200-250 U/L in 386 children, and ≥1 250 U/L in 231 children. Calcium was found 〈1.55 mmol/L in 79 children and ≥ 1.55 mmol/L in 676 children. The detection rate of abnormal BALP was 81.7% （617/755）, and that of abnormal calcium was 0.5% （79/755）. Calcium showed no statistically significant difference between different age groups and gender groups. The BALP showed no statistically significant difference between males and females, but significant differences between different age groups. The detection rate of abnormal BALP was highest in age group that smaller than one year old, but lowest in the age group from 3 to 5 years old. Most of the children were found with vitamin D deficiency, and the inci- dence increased as the age grows. Contusion BALP detection is more sensitive than calcium determination in the di-agnosis of vitamin D deficiency rickets, which can better reflect the nutritional status of calcium. Infants and children should have regular physical examination of the related projects in order to better prevent, control and treat rickets.