目的 探讨初诊原发性肾病综合征(PNS)患儿的骨代谢变化.方法 选择2013年2月至2016年7月初次诊断为PNS的45例患儿作为PNS组,将同期30例健康体检儿童纳入对照组;测定并比较两组血清钙、磷、骨碱性磷酸酶(BALP)、骨钙素(BGP)、I型胶原交联C末端肽(CTx)和血清抗酒石酸酸性磷酸酶5b(TRACP)、25-羟基维生素D [25(OH) D];采用超声检测骨密度(BMD).结果 PNS组患儿的BALP、CTx和25-(OH)D均高于对照组,BGP、TRACP、血Ca和骨密度水平(Z-分数)均低于对照组,差异有统计学意义(P<0.01);两组的血清磷水平差异无统计学意义(P>0.05).结论 初诊PNS患儿存在异常骨代谢,表现为钙质流失、骨形成减少、骨吸收增加等.%Objective To explore the changes of bone metabolism in children with newly diagnosed primary nephrotic syndrome (PNS). Methods Forty-five children diagnosed with PNS from February 2013 to July 2016 were selected into the PNS group, and 30 healthy children in the same period were enrolled in the control group. The serum calcium, phosphorus, bone alkaline phosphatase (BALP), osteocalcin (BGP), type I collagen cross linked C terminal peptide (CTx) and serum tartrate resistant acid phosphatase 5b (TRACP), and 25-(OH)D were measured and compared between two groups. Bone mineral density (BMD) was measured by ultrasound. Results The levels of BALP, CTx, and 25-(OH)D in the PNS group were higher than those in the control group, and the levels of BGP, TRACP, blood calcium, and BMD (Z- scores) in the PNS group were lower than those in the control group, and the differences were statistically significant (P<0.01). There was no significant difference in serum phosphorus between two groups (P>0.05). Conclusions Abnormal bone metabolism is found in children with newly diagnosed PNS and its manifestations include calcium loss, reduced bone formation, and increased bone resorption.
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