血清碱性磷酸酶在健康儿童和不同类型儿童佝偻病中的变化及意义

Changes and significance of serum alkaline phosphatase in rickets of healthy children and different types of children

目的 探讨血清碱性磷酸酶在健康儿童和儿童佝偻病中的活力变化。方法 选择2015年1月-2018年4月在永康市第六人民医院和绍兴市中心医院体检的4 905例0岁~18岁的健康儿童和儿童佝偻病患者,采用BECKMAN Dx C800全自动生化分析仪检测血清中碱性磷酸酶活力。结果 男童血清ALP活力显著高于女童,差异有统计学意义(P <0. 05),而且ALP活力在男童和女童0岁~0. 99岁时最高,随后男童ALP活力在13岁~14. 99岁时再次出现高值后逐渐下降但仍高于成人水平,女童ALP活力在11岁~12. 99岁时出现高值后至18岁基本与成人一致;维生素D依赖性佝偻病患者、营养型佝偻病患者和低血磷性佝偻病患者血清ALP水平均显著高于正常对照,差异有统计学意义(均P <0. 05)。结论 儿童血清ALP活力变化与性别和年龄密切相关,依据年龄和性别建立儿童血清骨碱性磷酸酶参考值为临床评估和早期发现儿童佝偻病提供了理论依据。

Objective To investigate the changes of serum alkaline phosphatase activity in healthy children and children with rickets.M ethods From February 2015 to April 2018,4905 healthy children and children with rickets from 0 to 18 years old in the Sixth People's Hospital of Yongkang and Shaoxing Central Hospital were selected to detect serum alkaline phosphatase activity in BECKMAN DxC800 automatic biochemical analyzer.Results The serum ALP activity of boys was significantly higher than that of girls,with the difference statistical significance(P<0.05),and the ALP activity was highest in boys and girls from 0 to 0.99 years old.Then the boy's ALP activity gradually decreased in 13-14.99 years old and then decreased.At the adult level,the ALP activity of girls is consistent with adults at the age of 11 to 12.99 years old.The serum ALP levels are significantly higher than those of patients with vitamin D-dependent rickets,nutritional rickets and hypophosphatemic rickets,with the differences statistically significant(P<0.05).Conclusion The changes of serum ALP activity in children are closely related to gender and age.Establishing reference range of serum alkaline phosphatase in children based on age and gender provides a theoretical basis for clinical evaluation and early detection of childhood rickets.