儿童生长痛与血清25羟维生素D水平及其它相关因素分析

Analysis of serum 25-hydroxy vitamin-D level and children′s growth pain and other related factors

目的分析血清25羟维生素D[25-(OH)D]水平及发生儿童生长痛(GP)及其它相关因素,为临床干预提供理论依据。方法2015年12月-2019年6月以北京市大兴区妇幼保健院收治的121例儿童GP患儿作为观察组,选取同期来本院体检的健康儿童121例作为对照组。观察组给予补充维生素D等综合治疗,观察疗效,并对比治疗前后儿童血清25-(OH)D、血钙、血磷及骨密度水平变化,并对可能发生GP的其他危险因素进行单因素、多因素分析。结果121例患儿经治疗后,有效105例,有效率为86.78%。25-(OH)D水平明显高于治疗前(P<0.01),接近对照组,与对照组比较差异无统计学意义(P>0.05);治疗前后血钙、血磷水平、超声骨密度比较,差异均无统计学意义(P>0.05),与对照组比较差异均无统计学意义(P>0.05);Logistic回归检验显示有家族史(OR=2.116,95%CI:1.653~2.879)、体育活动时间>2 h/d(OR=1.279,95%CI:1.038~1.508)、挑食(OR=2.745,95%CI:1.348~5.607)均是GP发生的危险因素(P<0.05或<0.01)。结论儿童GP可能与25-(OH)D水平有关,维生素D对于GP的治疗效果显著,对患儿骨营养状态进行评估并对其制定有效的治疗方案。

Objective To investigate the serum 25-hydroxy vitamin D[25-(OH)D]level and other related factors of children′s growth pain(growing pain,GP)Methods From December 2015 to June 2019,121 children with GP in Daxing District Maternal and Child Health Hospital were treated as the observation group,and 121 healthy children who came to our hospital for physical examination during the period were selected as the control group.Observation group was given comprehensive treatment such as vitamin D supplementation to observe the curative effect and compare the changes of serum 25-(OH)D,blood calcium,blood phosphorus and bone mineral density of children before and after treatment.Univariate and multivariate analysis of other risk factors for GP may occur.Results A total of 105 cases were effective,the effective rate was 86.78%;25-(OH)D was significantly higher than before treatment(P<0.01),close to the control group,no statistical significance compared with the control group(P>0.05);Blood calcium and blood phosphorus levels before and after treatment compared with ultrasound bone mineral density,the difference was not statistically significant(P>0.05),and compared with the control group was not statistically significant(P>0.05);Logistic regression test showed that family history(OR=2.116,95%CI:1.653~2.879),physical activity time>2 h/d(OR=1.279,95%CI:1.038~1.508),and picky eating(OR=2.745,95%CI:1.348~5.607)were all risk factors for GP.Conclusions Children′s GP may be related to 25-(OH)D levels.Vitamin D has a significant therapeutic effect on GP(P<0.05 or<0.01).The children′s bone nutritional status is evaluated and effective treatments are formulated.