骨碱性磷酸酶与碱性磷酸酶在佝偻病诊断中的比较

摘要

Objective To explore the significance of quantitative and qualitative measurements of bone alkaline phosphatase ( BAP-E and BAP-CIT ) and detection of serum AP in the diagnosis of rickets. Methods Serum AP level was measured, quantitative BAP was detected by ELISA, and qualitative BAP was determined by CIT in 55 children with rickets and 26 control subjects. Results AP level and BAP-E were ( 164.38 ± 23.87 ) U/L and ( 57.99 ± 7.67 ) U/L in controls, and were ( 209.50 ± 44.28 ) U/L, ( 80.38 ± 15.75 ) U/L, ( 206.06 ± 30.80 ) U/L, ( 78.05± 11.69) U/L, ( 1000.47 ± 464.65) U/L, and (283.22 ± 96.42) U/L in mild or severe rickets ,respectively. AP and BAP-E were elevated significantly in children with rickets ( P＜ 0.05 ), and there were significant differences between the severe groups and the mild groups ( P ＜ 0.05 ). AP positively related with BAP-E ( r= 0.921, P＜ 0.01 ) and BAP-CIT ( r= 0.49, P＜ 0.01 ). In the control group,BAP-CIT within the normal range was only in one patient and that beyond the normal range was in the remaining patients. Conclusions AP and BAP-E are positively correlated with the severity of rickets.AP may be used in severe patients. BAP-CIT should be used carefully in the diagnosis of rickets.%目的 了解定量骨碱性磷酸酶( BAP-E)、定性骨碱性磷酸酶(BAP-CIT)、血清碱性磷酸酶(AP)三个指标在佝偻病诊断中的意义。方法 检测55例佝偻病患儿、26例对照婴幼儿血清AP、BAP-E、BAP-CIT,BAP-E采用ELISA法，BAP-CIT用全血干化学和免疫浓缩技术。结果 佝偻病患儿的AP和BAP-E较对照组(164.38 U/L±23.87 U/L,57.99 U/L±7.67 U/L)明显增高（P＜0.05），中、重度组佝偻病患儿的AP和BAP-E( 1000.47 U/L±464.65U/L,283.22 U/L±96.42 U/L)较轻度组(209.50 U/L±44.28 U/L,80.38 U/L±15.75 U/L；206.06 U/L±30.80 U/L,78.05 U/L±11.69 U/L)明显增高（P＜0.05），对照组BAP-CIT仅1例在试剂盒的正常范围≤200 U/L，余皆在异常范围(200-300) U/L，AP与BAP-E、BAP-CIT均呈显著正相关（r=0.921,0.49,P＜0.01）。结论 AP、BAP-E与佝偻病的严重程度呈正相关，严重的佝偻病患儿可选用AP，BAP-CIT在佝偻病诊断的应用中要慎重。