目的 通过对泰州地区部分儿童血清25羟维生素D检测,了解健康儿童25羟维生素D水平,为佝偻病防治提供依据。方法 选取2013年10月-2014年9月儿保门诊儿童共476 例。取清晨空腹血,采用串联质谱法检测其血清25羟维生素D水平。结果 泰州市儿童各年龄组血清25羟维生素D水平均呈偏态分布,以中位数表示,分别为婴儿组、幼儿组、学龄前期组、学龄组。经秩和检验,不同年龄组维生素D水平差异有统计学意义(P<0.05)。各年龄组维生素D水平男女性别差异无统计学意义(P>0.05)。476例儿童中, 维生素D严重缺乏(≤5 ng/ml)占3.15%(15/476); 缺乏(≤15 ng/ml) 占38.45%(183/476);不足或以下(15～20 ng/ml)占17.86% (85/476);充足(>20 ng/ml)占40.55%(193/467) ;过量(>100 ng/ml)为0。维生素D不足(≤20 ng/ml) 的儿童占59.45% (283/476),其中婴儿组为9.3% (8/476);幼儿组为36.21%(42/467);学龄前组为70.13%(54/567 );学龄期组为90.86%(179/476),以学龄期儿童为主,各组间差异有统计学意义(P<0.05)。不同季节血清维生素D值差异有统计学意义(P<0.05)。结论 泰州市儿童维生素D水平随年龄增长而下降,学龄儿童维生素D缺乏尤为严重,3岁以上儿童需注意补充维生素D,尤其是冬季。

Objective To investigate 25-hydroxy vitamin D [25(OH)D] levels of healthy children in Taizhou by testing serum 25(OH)D of some children,and provide evidence for rickets. Methods A total of 476 children were enrolled in children healthcare outpatient clinic of Taizhou from October 2013 to September 2014.The blood samples were colleted on an empty stomach in the morning,and the serum 25(OH)D levels were detected by tandem mass spectrometry. Results The levels of 25(OH)D in serum of all age groups of children in Taizhou city were skewed distribution,with the median of that,as infant group,early childhood group,preschool group,school age group,respectively.After the rank sum test,the difference of vitamin D levels in different age groups was statistically significant (P<0.05).While there were no significant differences in the level of vitamin D in different age groups between boys and girls (P>0.05).476 children,a serious lack of vitamin D(≤5 ng/ml) (15/476) accounted for 3.15%;The lack (≤15 ng/ml) accounted for 38.45% (183/476);Under or below(15～20 ng/ml)accounted for 17.86% (85/476);Adequate (>20 ng/ml) accounted for 40.55% (193/467);Excess (>100 ng/ml) accounted 0.Vitamin D deficiency (≤20 ng/ml) children accounted for 59.45% (283/476),the infant group was 9.3% (8/476);Child group was 36.21% (42/467);preschool group was 70.13% (54/567);school age group was 90.86% (179/476),they were mainly school age children.There were significant differences among all groups (P<0.05) and statistically significant differences in serum vitamin D levels in different seasons (P<0.05). Conclusions The vitamin D levels of chinldren in Taizhou decreased with age,the lack of vitamin D in school age children is particularly serious.Therefore,children over the age of 3 need vitamin D supplementation,especially in winter.