目的：研究慢性肾病患儿血清1，25-二羟维生素D3水平与患者肾功能及并发症的关系，为临床运用维生素D治疗慢性肾病患儿奠定理论基础。方法：352例慢性肾病患儿根据不同分期分为CKDⅠ期组（56例）、Ⅱ期（132例）、Ⅲ期（79例）、Ⅳ期（43例）、Ⅴ期（42例），以45例健康儿童为对照组；比较各组患儿血清1，25-二羟维生素D3水平、生化指标；并根据1，25-二羟维生素D3的检测情况将慢性肾病患儿分为正常组（167例）和缺乏组（185例），比较两组并发症的发生情况。结果：Ⅴ期患儿Scr、Hb、Alb、P、1，25（ OH）2 D3与对照组、Ⅰ期均有统计学差异（ P＜0．05），慢性肾病患儿1，25-二羟维生素D3与Scr呈负相关；与Hb、Alb呈正相关，均具有统计学意义（ P＜0．05），慢性肾病患儿1，25-二羟维生素D3缺乏组贫血、身材矮小、高血压、慢性肾脏病的矿物质和骨代谢异常及高磷血症的发生率均高于正常组，差异有统计学意义（ P＜0．05）。结论：对慢性肾病患儿合理地使用维生素D3能有效延缓肾功能的损伤及并发症的发生。%Objective:To investigate the associations of 1,25-dihydroxyvitamin D3[1,25 (OH) 2D3] levels with renal damage and complications of chro-nic kidney disease( CKD) in CKD children for clinical evidence in vitamin D therapy of this entity .Methods:352 CKD cases were allocated to group of CKD Ⅰ(n=56),CKD Ⅱ (n=132),CKD Ⅲ(n=79),CKD Ⅳ(n=43) and CKD Ⅴ(n=42) by the disease stage,and another 45 healthy children were recruited as controls.Serum 1,25( OH) 2 D3 levels and biochemical indicators were determined and compared among groups .Then CKD children were subgrouped into normal level group(n=167) and level deficiency group( n=185) by the measured 1,25(OH)2D3 levels for compassion of the complica-tion prevalence.Results:The levels of serum creatinine(Scr),hemoglobin(Hb),albumin(Alb),serum phosphorus(P) and 1,25(OH)2D3 were statisti-cally different in children at CKD stage Ⅴ from the controls and those at CKD stage I(P<0.05).1,25 (OH) 2D3 levels were negative correlated with Scr levels,yet positively with Hb and Alb levels in CKD children.The difference was significant(P<0.05).CKD children with 1,25 (OH) 2D3 deficiency had higher incidences of anemia,short stature,hypertension,CKD-mineral and bone disorder as well as hyperphosphatemia than the control group(P<0.05). Conclusion:Rational supplementation of vitamin D3 in children with CKD may effectively reduce the kidney damage and complications associated with CKD.
展开▼
