Zecca E, Romagnoli C, Alecci M C, Gallini F, Maggio L, De Carolis M P, Vento G
Istituto di Clinica Pediatrica, Policlinico Universitario A. Gemelli, Roma.
Minerva Pediatr. 1992 Jan-Feb;44(1-2):5-10.
Osteopenia is a metabolic bone disease which affects a great deal of preterm infants. X-Ray evaluation is still the main step of the diagnostic and follow-up procedures. The Authors prospectively studied 77 newborn infants with birth weight less than 2500 grams, to identify specific clinical and biochemical features of the osteopenic infants. From the 2nd to the 12th week of life clinical, biochemical and radiological signs of osteopenia were looked for, every 2 weeks: the diagnosis of osteopenia was made on the basis of X-Ray. 26 osteopenic subjects with ga less than or equal to 32 weeks and/or bw less than or equal to 1500 grams were compared with 20 controls with ga less than or equal to 32 weeks and/or bw less than or equal to 1500 grams and with 31 control infants with ga greater than 32 weeks and bw greater than 1500 grams. Wider anterior funtanels, their progressively increasing dimensions, and craniotabe (with the "ping pong ball" sign) were the most characteristic features, as well as the increasing pattern of alkaline phosphatase activity, of the osteopenic babies. The Authors suggest a specific clinical and biochemical score to make the correct diagnosis and a non invasive follow-up in the osteopenic subjects and to avoid dangerous X-Ray exposure to babies that are not osteopenic.
骨质减少是一种代谢性骨病，影响大量早产儿。X线评估仍是诊断和随访程序的主要步骤。作者前瞻性地研究了77例出生体重小于2500克的新生儿，以确定骨质减少婴儿的特定临床和生化特征。在出生后第2周至第12周，每2周检查一次骨质减少的临床、生化和放射学征象：骨质减少的诊断基于X线检查。将26例胎龄小于或等于32周和/或出生体重小于或等于1500克的骨质减少患儿与20例胎龄小于或等于32周和/或出生体重小于或等于1500克的对照患儿以及31例胎龄大于32周且出生体重大于1500克的对照婴儿进行比较。较宽的前囟门、其尺寸逐渐增大以及颅骨软化（伴有“乒乓球”征）是骨质减少婴儿最具特征性的表现，碱性磷酸酶活性的增加模式也是如此。作者建议采用特定的临床和生化评分来进行正确诊断，并对骨质减少患儿进行无创随访，避免对非骨质减少的婴儿进行危险的X线照射。
