目的 探讨维生素D缺乏性佝偻病患儿破骨细胞功能状态,了解其与性别和年龄的关系。方法 选取符合维生素D缺乏性佝偻病诊断标准患儿有68例列入佝偻病组,健康婴幼儿66例列入对照组,检测血清25-(OH)D、抗酒石酸酸性磷酸酶5b(tartrate-resistant acid phosphatase isoform 5b,TRACP5b)、I型胶原交联羧基端肽(carboxyterminal cross-linking telopeptide,CTX),对所得结果采用SPSS 20.0软件进行数据分析处理。结果 维生素D缺乏性佝偻病组较对照组血清25-(OH)D、TRACP5b、CTX水平均低,有显著统计学差异,两组血清25-(OH)D水平婴儿较幼儿均低,两组血清TRACP5b、CTX水平婴儿较幼儿均高,差异有显著统计学意义。两组血清25-(OH)D、TRACP5b、CTX水平男女之间差异均无统计学意义。维生素D缺乏性佝偻病组血清TRACP5b、CTX与25-(OH)D水平呈负相关关系,血清TRACP5b与CTX水平呈正相关关系。结论 维生素D缺乏性佝偻病患儿破骨细胞活性明显活跃。婴儿破骨细胞活性较幼儿明显活跃,同年龄组不同性别之间破骨细胞活性无明显差异。TRACP5b和CTX是评价骨吸收的良好指标。破骨细胞分子标志物可作为维生素D缺乏性佝偻病的评价指标。

Objective To investigate osteoclast function levels in children with vitamin D deficiency ricket,and the relationship between the osteoclast function and sex,age. Methods A total of 68 infants and toddlers conformed to the standard were chosen as the case group,and 66 infants and toddlers in good health as the control group.Blood tested 25-hydroxyitamin D[25-(OH)D],tartrate-resistant acid phosphatase isoform 5b (TRACP5b),carboxyterminal cross-linking telopeptide (CTX) levels.Then the datum were analyzed by software SPSS 20.0. Results The levels of serum 25-(OH)D,TRACP5b,CTX concentration for the case group were all lower than the control group and the differences were significant.Between infants and toddlers,the level of serum 25(OH)D for the infants was lower,while the level of TRACP5b and CTX concentration for the toddlers were lower,and the differences were significant.There was no significant difference between different sex in 25-(OH)D,TRACP5b,CTX concentration levels.The serum TRACP5b,CTX had a negative correlation with the serum 25-(OH)D in case group.The correlation between serum TRACP5b and CTX in case group was positive. Conclusions The levels of osteoclast function in vitamin D deficiency ricket children are obviously active;The levels of osteoclast function in infants are more active than the toddlers.There is no big difference for the levels of osteoclast function between different sex in same age group;TRACP5b and CTX are good indexes for evaluating bone resorption.Osteoclast molecule markers will be the promising markers for evaluation of vitamin D deficiency ricket.