48例重型血友病儿童骨密度测定及相关因素分析

Investigation and analysis mineral density of 48 cases with severe hemophilia

目的描述我国重型血友病患儿的骨密度状况,探讨重型血友病患儿骨密度及相关影响因素。方法选取2015年7月-2015年8月在北京协和医院血友病门诊确诊为重型血友病的6～18岁患儿48例,采用超声骨质分析仪(BMD-1000C)对重型血友病患儿骨密度进行检测,对血清钙、磷、25(OH)VitD、运动、日照时间及钙摄入量等其他相关因素进行分析。结果 48例血友病患儿中7例(15%)中度骨密度减低,20例(42%)轻度骨密度减低;患儿均存在不同程度的25(OH)VitD缺乏;血友病患儿骨密度与血钙水平呈正相关(P<0.05)。结论重型血友病患儿骨密度较正常参考值低,且维生素D缺乏情况普遍存在,患儿骨密度水平与血钙水平相关。

Objective To describe the bone mineral density in children with severe hemophilia in China and to explore the bone mineral density and to analyze the possible factors contribute to it. Methods 48 children （6-18years） with hemophilia at the Hemophilia Clinic of Peking Union Medical College Hospital from July 2015 to August 2015 were collected. By using the BMD-1000C ultrasound bone analyzer detect the patients＇ bone mineral density. The serum calcium, phosphorus, 25 （OH） vitamin D, exercise, sunshine duration, calcium intake and other related factors were analyzed. Results Among 48 children patients, 7 of them （ 15% ） had a moderate reduction of bone mineral density and 20 of them （42%） had a mild reduction of bone density. All of the 48 children had different degrees of 25 （ OH ） vitamin D deficiency. There is a positive correlation between bone mineral density and serum calcium level in children with hemophilia （P 〈 0. 05 ）. Conclusions Compared with reference value, children with severe hemophilia have a lower bone mineral density with different degrees of 25 （ OH ） vitamin D deficiency. There is a positive correlation between bone mineral density and serum calcium level in children with hemophilia.