少儿膝关节夜间痛的相关性研究

Correlation analysis of serum osteocalcin and pain in knees in ad olescents and children at night

目的 探讨少儿膝关节夜间痛的相关因素及其防治。方法 测定常有膝关节夜间痛的少儿组 (A组 )与健康少儿对照组 (B组 )两组对象的骨钙素 (BGP)、血钙、磷、镁及碱性磷酸酶 (ALP)和骨密度 (BMD) ,并观察A组采用骨矿化剂阿法D3(α D3)治疗前和治疗后 1个月、3个月、6个月BGP的指标和夜间膝痛的变化。结果 结果显示A组的BGP明显高于B组 (P <0 0 1 ) ,其他血钙、磷、ALP及X线片均未见异常 ,部分少儿BMD有减低。采用VD3治疗 1个月后 ,BGP水平基本均恢复与对照组一致。但夜间疼痛在采用VD3治疗 1个月后仍有少数患儿时有发生 ,治疗 3个月后疼痛基本消失 ,而治疗 6个月和治疗 3个月则无明显差异。结论 膝关节夜间痛少儿虽然够不上佝偻病的诊断标准 ,但仍然与骨的矿化不足有一定的相关性 ,可能会与今后青春期骨峰量高低的形成有一定的关系。故提示临床上对于不明原因的少儿膝关节夜间痛应以BGP测定作为监测手段。如少儿膝关节夜间痛与BGP有关 ,则应采取积极的措施 ,如运用骨矿化剂维生素D3(VD3)

Objective To explore the relationship between serum osteocalcin (BGP) levels and pain in knees in adolescents and children at night, and the prevention and treatment of the pain Methods W e detected the BGP,b lood calcium,blood phosphorus,ALP and BMD in 42 adolescents and children,who wer e divided into two groups Group A (n=22) had the pain in knees at night; g roup B (n=20) were healthy controls Group A was treated with the bone mineraliz ation agent vitamin D 3 (VD 3) before and 1-3 and 6 months after treatment Results The BGP level in group A was significantly higher than that in group B(P<0 01),while the blood calcium,phosphorus,ALP and X-ray film re ve aled nothing remarkable,and some of them had a decline in BMD One month after t reatment with VD 3,the BGP largely returned to normal but the pain in knees at night was still present Three months after treatment the pain largely disappear e d,and there was no obviously difference betwen 6-month treatment and 3-month t re atment Conclusion Although the pain in knees in adolescents an d children at night can not reach the diagnostic criterion of rachitis, it is sti ll correlated with the deficiency in bone mineralization,and is likely correlate d with the formation of bone peak in adolescene Hence, in clinical practice,the BGP determination should be used as a means of monitoring for the pain of unknow n cause, in knees of adolescents and children at night If the pain in knees of adolescents and children at night is correlated with the BGP,it is important to take some active measures,such as treating with the bone mineralization agent VD 3