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目的:探讨不同亚型的非结石性特发性高钙尿症(IH)对儿童骨代谢的影响。方法:分别检测69例IH患者和30例健康儿童的血清总碱性磷酸酶(ALP)、骨特异性碱性磷酸酶(BALP)和骨钙素(BGP)水平,并行长骨X线摄片。结果:69例IH中肠吸收型(aIH)占56.5％(39/69),肾漏型(rIH)占24.6％(17/69),分类不明(unclassjfiable)的占18.9％(13/69)。rIH组和分类不明组的BALP各有23.5％(4/17)和15.4％(2/13)升高,BGP各有17.6％(3/17)和23.1％(3/13)升高;rIH组和分类不明组的BALP与BGP水平均高于对照组(rIH组P<0.05;分类不明组P<0.01)。前臂骨X线平片示6例存在轻度骨质疏松。结论:少数非结石性rIH或分类不明的非结石性IH患者存在轻微骨代谢异常,但一般不会对儿童骨骼发育造成显著影响。
Objective: To investigate the effects of different subtypes of non-stone idiopathic hypercalciuria (IH) on bone metabolism in children. Methods: Serum total alkaline phosphatase (ALP), bone specific alkaline phosphatase (BALP) and osteocalcin (BGP) were detected in 69 cases of IH patients and 30 healthy children. The long bone radiography was performed. Results: 69 cases (56.5%) had type I aIH, 24.6% (17/69) had renal leak type (rIH), 18.9% (13/69) had unclassified nonspecific classification, . 23.5% (4/17) and 15.4% (2/13) of BALP were increased in rIH group and in unknown classification group, 17.6% (3/17) and 23.1% (3/13) in BGP group, respectively; rIH The levels of BALP and BGP in the group with unknown classification and those with unknown classification were all higher than those in the control group (P <0.05 in rIH group; P <0.01 in classification unknown group). Forearm bone X-ray showed 6 cases of mild osteoporosis. CONCLUSIONS: A small number of non-stone rIH or unclassified non-stone-bearing IH patients have minor abnormalities of bone metabolism, but generally do not have a significant impact on children’s skeletal development.