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首页> 外文期刊>Journal of paediatrics and child health >Metabolic bone disease of prematurity and secondary hyperparathyroidism.
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Metabolic bone disease of prematurity and secondary hyperparathyroidism.

机译：早产代谢性骨病和继发性甲状旁腺功能亢进。

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AIM: To illustrate, via case histories, the importance of laboratory investigations for the early diagnosis and management of metabolic bone disease (MBD). METHODS: We report three cases of extreme premature infants with MBD. RESULTS: These three infants had several risk factors for MBD of prematurity: very low birthweight, delayed enteral feeds, cholestatic liver disease, intolerance of fortification, the use of glucocorticoids and diuretics. Serum alkaline phosphatase and parathyroid hormone (PTH) were elevated despite relatively normal calcium and phosphate levels. These parameters were corrected with additional supplementation of calcium, phosphate and vitamin D. CONCLUSIONS: Infants born extremely prematurely have significant calcium and phosphate depletion by the time they reach full term compared with the normal fetal accretion rate. This is exacerbated if there is poor tolerability to feeds where extra calcium and phosphate could not be added either by additives or via human milk fortifier. Serum calcium and phosphate levels may be normal despite inadequate intake or stores due to the counter-regulatory effect of PTH. In infants at risk of MBD, testing serum alkaline phosphatase, vitamin D and PTH with calcium and phosphate may assist in the monitoring and management of MBD.
机译：目的：通过病例历史说明实验室研究对代谢性骨病（MBD）的早期诊断和管理的重要性。方法：我们报告了三例MBD的极端早产儿。结果：这三个婴儿早产儿MBD有几个危险因素：极低的出生体重，延迟的肠内进食，胆汁淤积性肝病，不耐受强化，使用糖皮质激素和利尿剂。尽管钙和磷酸盐水平相对正常，但血清碱性磷酸酶和甲状旁腺激素（PTH）仍升高。通过补充钙，磷酸盐和维生素D校正了这些参数。结论：与正常胎儿的增生率相比，过早出生的婴儿在达到足月时具有明显的钙和磷酸盐消耗。如果对饲料的耐受性差，而不能通过添加剂或人乳强化剂添加额外的钙和磷酸盐，则会加剧这种情况。尽管摄入或储存不足，但由于PTH的反调节作用，血清钙和磷酸盐水平仍可能是正常的。在有MBD风险的婴儿中，用钙和磷酸盐检测血清碱性磷酸酶，维生素D和PTH可能有助于监测和管理MBD。

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