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秘鲁儿童的成骨不全症:一家儿科医院的表型与治疗见解

Osteogenesis imperfecta in Peruvian children: Phenotypic and therapeutic insights from a pediatric hospital.

作者信息

Barba Andres Alberto Alayza, Meza Paloma Valeria Matos, Abarca-Barriga Hugo Hernán

机构信息

Carrera Profesional de Medicina Humana, Universidad Científica del Sur, Lima, Perú.

Servicio de Genética & Errores Innatos del Metabolismo, Instituto Nacional de Salud del Niño - Breña, Lima, Perú.

出版信息

Intractable Rare Dis Res. 2024 Nov 30;13(4):236-244. doi: 10.5582/irdr.2024.01033.

Abstract

Osteogenesis imperfecta (OI) is a genetic disorder of the connective tissue that is characterized by high bone fragility. It has a worldwide incidence of 1 in 10,000. The diagnosis is mainly clinical-radiological. Treatment is based on the use of bisphosphonates and orthopedic surgeries. The objective of this study was to establish the clinical, radiological, and therapeutic characteristics of OI in pediatric patients of a national reference pediatrics institute. This was conducted through a descriptive and retrospective analysis. All patients under 18 years of age with a diagnosis of OI treated at the Instituto Nacional de Salud del Niño de Breña (INSN-Breña) between 2010 and 2021 were included. In total, 91 patients with OI were studied, more than half of whom were male. A total of 93.4% had a history of fractures, 72.5% had blue sclera, 39.6% had bowed legs and 20.9% had dentinogenesis imperfecta. The minimum-maximum value of fractures was 0-18. A total of 75.8% of patients started treatment with bisphosphonates and 41.8% used adjuvant medications. Less than 50% of patients required surgical treatment. Osteogenesis imperfecta is a genetic and chronic pathology. The use of the Van Dijk severity grade and the Aglan severity scale is simple to apply and therefore should be used to improve the classification of groups with the highest risk of fractures and response to treatment. Due to the low incidence of this disease, it is important to raise awareness and increase the research volume on this subject.

摘要

成骨不全症(OI)是一种结缔组织的遗传性疾病,其特征是骨脆性高。全球发病率为万分之一。诊断主要基于临床和放射学检查。治疗方法主要是使用双膦酸盐和进行矫形手术。本研究的目的是确定一家国家参考儿科研究所中儿科OI患者的临床、放射学和治疗特征。这是通过描述性回顾性分析进行的。纳入了2010年至2021年间在布雷尼亚国家儿童健康研究所(INSN-Breña)接受治疗的所有18岁以下诊断为OI的患者。总共研究了91例OI患者,其中一半以上为男性。共有93.4%的患者有骨折史,72.5%有蓝色巩膜,39.6%有膝内翻,20.9%有牙本质发育不全。骨折次数的最小值-最大值为0-18次。共有75.8%的患者开始使用双膦酸盐治疗,41.8%的患者使用辅助药物。不到50%的患者需要手术治疗。成骨不全症是一种遗传性慢性疾病。使用范迪克严重程度分级和阿格兰严重程度量表应用简单,因此应用于改善骨折风险最高和对治疗反应的分组分类。由于这种疾病的发病率较低,提高对该疾病的认识并增加相关研究量很重要。

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本文引用的文献

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