摘要目的 分析69例维生素D过量病例的血清25-羟基维生素D[25-(OH)D]水平、血清钙及钙磷乘积(CPP)的关系.方法 血清25-(OH)D水平采用酶联免疫法检测,收集2009年至2011年2、3、9、10月份本医疗中心13502例0 ～ 17周岁体检儿童的血清25-(OH)D结果,计算各年龄组维生素D过量、中毒的情况.对比VD过量[(25-(OH)D水平250 ～ 375.0 nmol/L]与中毒组[(25-(OH)D水平≥375.0nmol/L)血清Ca、IP、ALP、钙磷乘积(CPP),并做血清Ca、CPP、VD的相关分析.结果 13502例儿童中,过量和中毒分别为34例(0.25％)、35例(0.26％),血清Ca最大值2.78 mmol/L,仅3例Ca＞2.74 mmol/L,两组间Ca、IP、ALP、CPP比较差异无统计学意义(P＞0.05),血清Ca与CPP的Pearson相关分析:相关系数为0.762,P=0.000,血清Ca与CPP呈正的直线相关,血清Ca与VD、CPP与VD无明显直线相关.过量组与中毒组的总69例和CPP超过60的36例以CPP分别做秩和检验,Marm-Whitney U分别等于427.500、88.000,P值分别等于0.044、0.025,差异有统计学意义.结论 这一组VD过量病例血清Ca无明显升高,随着VD水平的增高,CPP超过60的病例明显增加,提示有潜在软组织钙化的可能.

abstractsObjective To analyze the levels of 25-hydroxyvitamin D [25-(OH)D],serum calcium,and calcium-phosphorus product (CPP) in 69 cases of vitamin D excess and the relationships among them.Methods The serum 25-(OH)D level was detected by enzyme-linked immunosorbent assay kit in 13 502 children aged from 0 to 17 years old that took health examination in our hospital from September 2009 to March 2011.The rates of vitamin D excess,and poisoning were calculated for each age group.Compared the levels of serum Ca,IP,ALP,and CPP of children with VD excess [25-(OH)D 250-375.0 nmol/L] and children with VD poisoning [25-(OH)D ≥375.0 nmol/L],and did the correlation analysis of serum Ca,CPP,and VD.Results In 13 502 children,there were 34 cases (0.25％) of VD excess and 35 cases (0.26％) of VD poisoning.The maximum value of serum Ca was 2.78 mmol/L,there were only 3 cases with serum Ca＞2.74 mmol/L.There were no statistically significant differences in Ca,IP,ALP,and CPP between the two groups (P＞0.05).There was positive linear correlation between serum Ca and CPP (r=0.762,P=0.000);there were no obvious linear correlation between serum Ca and VD,CPP and VD.There were statistically significant differences in the intergroup rank-sum test in 69 cases of excess and poisoning and 36 cases of CPP more than 60 (Mann-Whitney U=427.500,88.000;P=0.044,0.025).Conclusions Serum Ca had no obvious rise in this set of VD excess cases,the cases with CPP more than 60 significantly increased with the VD level increased,which suggested the possibility of potential soft tissue calcification.