极低出生体重早产儿血清磷、骨碱性磷酸酶、25-羟基维生素D水平动态变化分析

Study on levels of serum phosphorus, bone alkaline phosphatase and 25-hydroxyvitamin D in preterm infants with very low birth weight

目的 调查分析极低出生体重早产儿血清磷（P）、骨碱性磷酸酶（BALP）、25-羟基维生素D[25-（OH）D3]水平动态变化,为临床早产儿代谢性骨病的早期预防提供指导.方法 选择入住烟台山医院新生儿科病房且符合入选标准的110例新生儿为研究对象,其中极低出生体重早产儿60例（病例组）,足月产儿50例（对照组）,分别于出生后1、4、12周空腹采取静脉血2 ml,测定血清P、BALP、25-（OH）D3水平,分析骨代谢指标的变化情况.结果 病例组25-（OH）D3水平增长速度低于对照组;两组血清P水平无明显变化.与对照组比较,病例组出生后1、4、12周血清BALP水平均显著性偏高;出生后第12周25-（OH）D3水平的差异有统计学意义,其中病例组异常率达26.7％,对照组异常率为0.结论 极低出生体重早产儿（病例组）出生后追赶性生长过程中血清BALP、25-（OH）D3水平与足月儿（对照组）有明显差异,提示该两项指标检测有助于极低出生体重儿代谢性骨病的早期发现及干预,其中以血清BALP指标敏感性较好.

Objective To compare the levels of serum phosphorus,bone alkaline phosphatase and 25-hydroxyvitamin D3 in preterm infants with very low birth weight, and provide evidence for early screening, prevention of metabolic bone disease in preterm infants.Methods A total of 110 newborns who met the inclusion criteria were selected in pediatric ward in our hospital.The case group included 60 preterm infants with very low birth weight and control group included 50 full term infants.Fasting blood were taken from the subjects at week 1, 4, and 12 respectively, and ELISA was conducted to quantitatively detect the serum levels of phosphorus, bone alkaline phosphatase and 25-hydroxyvitamin D.Results The increase of serum 25-hydroxyvitamin D3 in case group was smaller than that in control group;the levels of serum phosphorus had no significant difference between two groups.In case group, the level of bone alkaline phosphatase increased at week 1,4, and 12, and the 25-hydroxyvitamin D3 level had significant difference at week 12 （P〈0.05）.The abnormal rate of 25-hydroxyvitamin D3 level was 26.7% for case group and 0% for control group.Conclusion There were significant differences between case group and control group in levels of bone alkaline phosphatase and 25-hydroxyvitamin D3, suggesting that detecting the serum levels of bone alkaline phosphatase and 25-hydroxyvitamin D3 would facilitate the early diagnosis of metabolic bone disease in preterm infants.