目的 通过探讨婴儿维生素D水平与超声骨密度及身长发育等因素的关系,旨在及早的发现婴儿维生素D缺乏性佝偻病的高危因素,为确定维生素D缺乏性佝偻病的诊断标准提供依据。方法 选取2010年3月-2011年4月在本院出生,并在儿保科常规建册系统管理的9个月婴儿337例,根据生长发育指标测量方法进行体重、身长的体格测量并记录,同时进行喂养方式等相关问卷调查。9个月体检时采集婴儿静脉血5 mL,采用酶联免疫法(ELISA)检测血清25-(OH)D浓度;进行婴儿胫骨SOS测量,并采用Z值进行比较,了解骨矿化状况。并采用单因素方差分析及独立样本t检验等进行婴儿维生素D水平与超声骨密度及身长发育等的关系分析;结果 不同喂养方式、母乳喂养持续时间、户外活动时间比较,其不同组间的维生素D水平及超声骨密度Z值均有差异(P均＜0.05)。婴儿不同组间的25-(OH)D,其骨密度Z值及身长差异有统计学意义(P＜0.05)。结论 婴儿的维生素D营养状况与婴儿的骨矿物质含量密切相关,合理适量的补充维生素D是今后儿保工作的重点。证实了25-(OH)D是诊断维生素D缺乏性佝偻病的金标准。

Objective To explore the relationship between infant vitamin D level and ultrasonic bone mineral density and height development,and to discover the high risk factors of infants with vitamin D deficiency rickets,and provide the basis for the confirmed diagnosis of vitamin D deficiency rickets. Methods 337 cases of 9 months old infants born from in March 2010 to in April 2011 in our hospital and in routine register system management of the children's health section were selected.Weight and height were measured and recorded according to the indexes measuring method of growth and development and the questionnaire survey of feeding patterns was collected.5mL infant venous blood was collected in 9 months' medical examination,Serum 25-(OH) D was detected by ELISA,infant tibia SOS was measured by 7000P bone ultrasound intensity meter provided by the Sunlight Omnisense.Bone mineralization condition was showed and compared by Z value.The relationship between infant vitamin D level and ultrasonic bone mineral density and height development was analysed by the single factor variance analysis and independent sample t test. Results Different feeding methods,duration of breast feeding and the time for outdoor activities were compared,there were differences in the different groups of vitamin D level and ultrasonic bone mineral density in Z value (P<0.05).There was a significant difference in 25-(OH)D,ultrasonic bone mineral density Z value and height in the different groups(P<0.05). Conclusions Infant vitamin D nutritional status is closely related to bone mineral content.Reasonable amount of vitamin D is the future focus of child protection work.It was confirmed 25-(OH)D is the gold standard for the diagnosis of vitamin D deficiency rickets.The examination of infant serum 25-(OH)D of conditional units is suggested.