儿童骨折后血清25-羟基维生素D含量变化及临床意义

Changes and clinical significance of serum 25-hydroxy vitaminD_3 in children with fracture

目的研究儿童骨折后血清中25-羟基维生素D的含量与正常儿童血清中25-羟基维生素D含量的差异。方法选取我院2014年8月至2017年6月3~15岁骨折患儿100例作为观察组,另随机选取3~15岁家属要求体检的健康患儿100例作为对照,抽取其外周血3 ml,提取血清,采用电化学发光法检测骨折儿童和对照组血清中25-羟基维生素D含量。结果观察组儿童血清25-羟基维生素D含量明显低于对照组,差异有统计学意义(P<0.05);观察组第1~4 d几丁质酶3样蛋白(CHI3L1)表达水平明显高于对照组(P<0.05),之后CHI3L1表达水平开始下降,第6 d时与对照组相比差异无统计学意义(P>0.05);患儿血清中25-羟基维生素D含量与CHI3L1表达水平呈现明显负相关(P<0.05)。结论儿童骨折后血清中25-羟基维生素D含量相对非骨折组水平较低。在儿童骨折治疗中补充外源性维生素D,加强抗感染治疗,可促进骨折愈合,降低骨折延迟愈合、骨不愈合的发生率。

Objective To investigate the difference of serum 25-hydroxyvitarain D3 levels between children with fracture and normal non-fracture children.Methods One hundred patients with fractures aged from 3 to 15 years old in our hospital were selected as experimental group and 100 healthy non-fracture patients aged 3-15 years were taken as control group.Three ml of peripheral blood were collected and serums were separated.The serum concentration of 25-hydroxyvitamin D3 was determined by electrochemilumines- cence （ECL）.Results The serum concentrations of 25-hydroxyvitamin D3 in the fracture group were significantly lower than that in the control group （P 〈0.05） .The expression of chitinase 3-like protein （ CHI3L1） on the 1st to 4th day in the fracture group was sig-nificantly higher than that in the control group （P 〈 0.0 5 ） . Afterwards, the expression of CHI3L1 began to decrease,and there was no significant difference between the fracture group and the control group on the 6 th day （ P〉0.05 ）.There was a significant negative correlation between serum 25-hydroxyvitamin D3 and CHI 3L1 expression （P 〈 0.05） .Conclusion The level of 25 -hydroxyvitamin D3 in children after fracture is lower than that in non-fracture children.Supplementation of exogenous vitamin D in the treatment of children with fracture and strengthening the anti-infective therapy can promote the fracture healing and reduce the incidence of delayed bone union and nonunion.