脑性瘫痪儿童骨质疏松相关指标调查研究

The investigation on related indicators of osteoporosis in children with cerebral palsy

目的 调查8岁以下不同类型脑性瘫痪(CP)儿童骨质疏松症指标的分布及相关因素影响情况。方法 选取2020年4月至2022年12月该院收治的0~8岁CP儿童74例,记录74例儿童的体重指数、维生素D、血钙、骨密度(BMD)等骨质疏松指标,结合其相关因素[CP分型、步行能力分类、粗大运动功能分级系统(GMFCS)分级、性别、年龄等]进行分析。结果 不同CP分型儿童骨矿含量(BMC)、BMD、血红蛋白、血钙、维生素D水平等比较,差异均有统计学意义(P<0.05),痉挛型四肢瘫儿童异常情况最明显;不同GMFCS分级儿童BMC、BMD、血红蛋白、维生素D水平等比较,差异均有统计学意义(P<0.05),随GMFCS分级升高相关指标普遍下降;下肢很少负重的CP儿童BMD、维生素D水平最低,差异均有统计学意义(P<0.05);随GMFCS分级升高,低Z值比例明显增加,1~2级为61.70%,3级为64.28%,4~5级为76.92%。结论 CP儿童骨质疏松异常指标比例偏高,其中四肢瘫、中重度及不能行走的CP儿童情况尤其明显,值得关注。

Objective To investigate the distribution of osteoporosis indicators and influence of related factors in children with different types of cerebral palsy(CP) under eight years old.Methods From April 2020 to December 2022,a total of 74 children with CP aged 0-8 years of this hospital were selected.And their osteoporosis indexes such as body mass index(BMI),vitamin D,blood calcium,bone mineral density(BMD) and other osteoporosis indicators were recorded and analyzed by combing with its related factors(CP classification,walking ability classification,GMFCS,gender and age,etc.).Results There were statistically significant differences in bone mineral content(BMC),BMD,hemoglobin,blood calcium and vitamin D levels in children with different CP types(P<0.05),and the abnormality situation in children with spastic quadriplegia was the most obvious.Compared with the levels of BMC,BMD,hemoglobin and vitamin D of children with different GMFCS grades,the differences were statistically significant(P<0.05),and the related indexes generally decreased with the increase of GMFCS grades.The levels of BMD and vitamin D of CP children with little weight support in lower limbs were the lowest,and the differences were statistically significant(P<0.05).With the increase of GMFCS grade,the proportion of low Z value increased significantly with grades one-two being 61.70%,grades three being 64.28%,and grades four-five being 76.92%.Conclusion The proportion of abnormal indicators of osteoporosis in children with CP is relatively high,especially in children with quadriplegia,moderate to severe and unable to walk,which deserves attention.