【摘要】 目的:探讨特发性肾病综合征(INS)活动期对儿童骨代谢的影响。方法:检测比较48例初发且未经激素治疗的活动期INS患儿和30例正常的健康儿童(对照组)的血清钙(Ca)、磷(P)、总碱性磷酸酶(TALP)、甲状旁腺素(PTH)、骨特异性碱性磷酸酶(BALP)和骨钙素(OC)水平,并摄前臂骨X线片。结果:INS组血清Ca、OC水平低于对照组(P<0.01),血清BALP、PTH水平较对照组升高(P<0.01),血清P、TALP水平与对照组比较差异不显著(P>0.05);INS患儿中,24 h尿蛋白定量≥0.2 g/kg亚组与24 h尿蛋白定量<0.2 g/kg亚组比较,血清Ca、OC水平明显降低(P<0.01),而血清BALP水平明显升高(P<0.05),血清PTH水平差异无显著性(P>0.05)。48例INS患儿的前臂骨摄片均未见异常改变。结论:特发性肾病综合征活动期患儿存在骨代谢异常,血清BALP、OC水平能敏感地反映其骨代谢变化。更多还原

【Abstract】 Objective: To explore the effect of idiopathic nephrotic syndrome(INS)at active stage on bone metabolism in children.Methods:The serum levels of calcium(Ca),phosphorus(P),total alkaline phosphatase(TALP),parathyroid hormone(PTH),bone-specific alkaline phosphatase(BALP) and osteocalcin(OC) were measured in 48 children with INS who had not been treated with glucocorticoid at active stage and 30 healthy ones(as control group).Moreover,the focile roent-genogram was examined in each INS children.Results:The serum levels of Ca and OC in INS group were significantly lower than those in control group(P<0.01);The serum levels of BALP and PTH in INS group were obviously higher than those in control group(P<0.01);The serum levels of P and TALP in INS group did not changed notably compared with control group(P>0.05).Compared with the subgroup of 24 h urine protein<0.2 g/kg,the serum levels of Ca and OC of the children in the subgroup of 24 h urine protein≥0.2 g/kg were significantly lower(P<0.01),and the serum level of BALP was significantly higher(P<0.05),but the serum level of PTH were alike(P>0.05).The focile roentgenograms in 48 INS children were all normal.Conclusion:These results suggest that the children with INS at active stage have abnormal bone metabolism,and the serum levels of BALP and OC can reflect the changes of bone metabolism sensitively.更多还原