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重度残疾的寄养儿童和青少年的骨定量超声与营养状况

Bone quantitative ultrasound and nutritional status in severely handicapped institutionalized children and adolescents.

作者信息

Hartman C, Brik R, Tamir A, Merrick J, Shamir R

机构信息

Division of Pediatric Gastroenterology and Nutrition, Meyer Children's Hospital, Israel.

出版信息

Clin Nutr. 2004 Feb;23(1):89-98. doi: 10.1016/s0261-5614(03)00096-7.

Abstract

BACKGROUND & AIMS: Children with cerebral palsy (CP) have a high prevalence of pathologic fractures. Bone quantitative ultrasonography (QUS) has emerged as a radiation-free method for the assessment of bone quality and fracture risk. In this study, we applied QUS technique in order to investigate bone status in handicapped institutionalized children and adolescents.

METHODS

This cross-sectional study included 87 handicapped institutionalized patients. Measurements of the velocity of ultrasound wave, speed of sound (SOS), at distal radius and midshaft tibia, were performed using Omnisense 7000S analyser (Sunlight Ltd., Tel Aviv, Israel). In addition, all the participants had a thorough evaluation of nutritional status, demographic and clinical characteristics.

RESULTS

Forty-five of patients had either radius or tibia bone SOS lower than -1 SD, and 21% had either radius or tibia bone SOS lower than -2.5 SD. Using step-wise regression analysis, female gender (P=0.003) and stature (P=0.008) were correlated with radius SOS. Age (P=0.03) and fracture history (P=0.04) were negatively correlated with tibia SOS.

CONCLUSION

In this group of children and adolescents with CP one-fifth had poor bone status as suggested by low tibia/radius SOS assessed by QUS. Female gender, stature, age and fracture history were significantly correlated with poor bone status.

摘要

背景与目的

脑瘫(CP)患儿病理性骨折的患病率很高。骨定量超声检查(QUS)已成为一种无辐射的评估骨质量和骨折风险的方法。在本研究中,我们应用QUS技术来调查残疾福利院儿童和青少年的骨骼状况。

方法

这项横断面研究纳入了87名残疾福利院患者。使用Omnisense 7000S分析仪(以色列特拉维夫阳光有限公司)测量桡骨远端和胫骨中段的超声波速度,即声速(SOS)。此外,所有参与者都对营养状况、人口统计学和临床特征进行了全面评估。

结果

45名患者的桡骨或胫骨骨SOS低于-1标准差,21%的患者桡骨或胫骨骨SOS低于-2.5标准差。采用逐步回归分析,女性(P=0.003)和身高(P=0.008)与桡骨SOS相关。年龄(P=0.03)和骨折史(P=0.04)与胫骨SOS呈负相关。

结论

在这组脑瘫儿童和青少年中,五分之一的患者胫骨/桡骨SOS较低,提示骨状况不佳。女性、身高、年龄和骨折史与骨状况不佳显著相关。

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