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目的 研究维生素D(VitD)缺乏性佝偻病患儿骨胶原合成与分解的状况 ,探讨其与骨特异性骨碱性磷酸酶 (BALP)之间的相关性。方法 按照佝偻病临床诊断标准确定 2 0 0 1年 11月至 2 0 0 3年 1月河北医科大学附属二院及大同市第一人民医院儿科 14 8例研究对象 (佝偻病组 80例 ,对照组 6 8例 ) ,结合血清 2 5 羟维生素D(2 5 OHD)及BALP检测结果 ,经过两次筛查 ,明确最后研究对象为佝偻病组 4 3例 ,对照组 37例 ,用酶联免疫方法检测其血清I型前胶原羧基末端前肽 (PICP) ,I型胶原羧基末端交联 (crosslaps)水平。结果 佝偻病患儿血清PICP、crosslaps水平均高于正常组 ,且差异均有显著性意义。佝偻病组及正常组除血清BALP、PICP有正相关关系且有统计学意义 ,其他指标间均无相关性。结论 VitD缺乏性佝偻病患儿骨胶原的合成增强 ,并与骨碱性磷酸酶有相关性。PICP可否作为佝偻病早期诊断的指标需进一步研究。VitD缺乏性佝偻病患儿骨胶原的分解增强。佝偻病患儿骨胶原代谢处于高转换状态。
Objective To study the status of collagen synthesis and degradation in children with vitamin D deficiency rickets and to explore its relationship with bone specific bone alkaline phosphatase (BALP). Methods According to the clinical diagnostic criteria of rickets, 141 cases of obstetrics and gynecology in the Second Affiliated Hospital of Hebei Medical University and the First People ’s Hospital of Datong from November 2011 to January 2003 were enrolled in this study. Among them, 80 cases of rickets group and 6 cases of control group 8), combined with serum 25 dihydroxyvitamin D (25 OHD) and BALP test results, after two screening, the final study was confirmed as 43 cases of rickets and 37 cases of control group, the enzyme-linked immunosorbent assay Serum type I procollagen carboxyterminal propeptide (PICP), type I collagen carboxy-terminal crosslaps levels. Results The serum levels of PICP and crosslaps in children with rickets were significantly higher than those in normal controls, and the differences were significant. There was a positive correlation between the rickets and normal group except serum BALP and PICP, and there was no significant difference between the other indexes. Conclusion The synthesis of collagen in children with VitD-deficient rickets is enhanced and correlated with bone alkaline phosphatase. PICP can be used as an indicator of early diagnosis of rickets for further study. Collagen degradation in children with VitD deficiency rickets is enhanced. Children with rickets collagen metabolism in a high state of conversion.