极度早产婴儿的代谢性骨病:发病率,风险因素和结构化骨健康计划的结果
Saif Alsaif1,2,3, Mohanned Alrahili1,3, Talal Aljarbou1
1Neonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Frontiers in pediatrics
|December 11, 2025
概括
代谢性骨病 (MBD) 在极度早产婴儿中很常见,导致生长失败和更长的住院时间. 使用副甲状腺激素 (PTH) 查的早期检测可以改善新生儿重症监护室的结果.
科学领域:
- 新生儿科学 新生儿科学
- 儿科内分泌学 儿科内分泌学
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 过早的代谢性骨病 (MBD) 是极其早产和极低出生体重 (ELBW) 婴儿的一个重大问题.
- 对于中东的MBD存在有限的区域数据,需要进行本地化研究.
- 这项研究侧重于孕期<28周和<1,000克的婴儿.
研究的目的:
- 为了评估MBD的发病率,危险因素,生化标志物和结局,在一个极度早产婴儿队列.
- 评估副甲状腺激素 (PTH) 水平在诊断MBD及其与放射性骨质疏松症相关性的有用性.
- 确定MBD的预测因素及其与此脆弱人群中不良结果的关联.
主要方法:
- 一项对487名早产婴儿的回顾性队列研究,这些婴儿被录入沙特阿拉伯利雅得的三级NICU (2017-2024年).
- 在4周内,MBD被定义为PTH水平>18 pmol/L,与接受器操作特征 (ROC) 对放射性骨质疏松症的分析.
- 临床特征,营养摄入量,生长和生化标志物 (ALP,酸盐,,维生素D,PTH) 用后勤回归分析.
主要成果:
- 在41.5%的婴儿中诊断出MBD,与较低的妊娠年龄,出生体重,以及增加对产后类固醇,利尿剂和长期TPN的暴露有关.
- 患有MBD的婴儿表现出较高的PTH和ALP,以及较低的维生素D,和水平.
- 尽管摄入相似的/酸盐,MBD独立预测了骨折,长时间住院 (>60天) 和生长失败.
结论:
- 在极度早产的婴儿中,MBD很普遍,大大导致生长衰竭和延长住院治疗.
- 4周的PTH查显示了放射性骨质疏松症的良好歧视,支持其在结构化骨健康护理中的作用.
- 研究结果表明,针对长期TPN,利尿剂和类固醇等可修改性暴露来预防MBD,并强调需要对诊断值进行外部验证.
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