摘要
目的 分析哺乳期妇女与非孕产妇女骨代谢和骨密度的差异,综合评估哺乳期妇女骨代谢状况,探讨哺乳期妇女维生素D(VD)血清含量与其哺乳婴儿的生长发育的关系.方法 收集2017年11月至2018年6月行纯母乳喂养的66例产后40~60d哺乳期妇女及其纯母乳喂养婴儿(日龄30~40d)的临床资料,并与同期体检健康的非孕产妇女30例作对照.检测两组妇女羧基端肽(β-CTx)、I型胶原氨基端前肽(PINP)、VD及超声跟骨骨密度,同时监测婴儿的生长发育情况.结果 哺乳期妇女血清羧基端肽(β-CTx)、I型胶原氨基端前肽(PINP)均明显高于健康非孕产妇女(P<0.05),且β-CTx/?PINP值较健康非孕产妇女升高(P<0.05);哺乳期妇女骨量较健康非孕产妇女减少(P<0.05),其血清VD水平异常率高于健康非孕产妇女(P<0.05);同时,VD正常组婴儿的身高增长优于VD缺乏组婴儿(P<0.05),两者呈等级正相关关系(r'=0.373).结论 哺乳期妇女骨代谢较活跃,骨吸收和骨形成均显著增强,且骨吸收增强常较骨形成更为明显;哺乳可致乳母骨量减少,并伴血VD的下降;血VD下降可致其哺乳婴儿身高增长减缓.因此建议哺乳期妇女应继续适量补充VD和钙,并建议骨代谢生化指标联合骨密度检测,可推荐用于哺乳期妇女的监测以便更好地指导临床.
Objective To analyze the differences of bone metabolism and bone mineral density between lactating women and non-lactating women,comprehensively evaluate the bone metabolism of lactating women,and explore the relationship between serum VD levels and the growth of lactating infants in lactating women.Methods The clinical data of 66 postpartum 40-60d lactating women and their exclusively breast-fed infants(days 30~40d)who were exclusively breastfed from November 2017 to June 2018 were collected and compared with the healthy non-pregnant women.Thirty women were used as controls.The level ofβ-CTx,PINP,VD and ultrasonic bone mineral density in serum were measured in both groups,and the growth data of the baby were monitored.Resultsβ-CTx and PINP were significantly higher in lactating women than in healthy non-pregnant women(P<0.05),and the values ofβ-CTx/PINP were higher than the data in control group.The bone mass in lactating women was lower than that in healthy non-maternal women(P<0.05),and the abnormal rate of serum VD was higher than that in healthy non-maternal women(P<0.05).Meanwhile,The growth of the normal group in VD-sufficient group was better than that of in VD-deficient group(P<0.05),and it was a positive correlation(r'=0.373).Conclusion The bone metabolism in lactating women is more active.The bone resorption and bone formation are significantly enhanced in lactating women,moreover bone resorption is more obvious than bone formation.Lactation would reduce the bone mass in breast milk and decrease the content of VD in blood.Blood VD decrease can restrain the breast-feeding baby's growth.Therefore,it is recommended that lactating women should continue to supplement VD and calcium in appropriate amounts,and biochemical indicators of bone metabolism combined with bone mineral density testing are recommend,which can be an indicator for lactating women for better guide clinical practice.
出处
《浙江临床医学》
2019年第5期668-670,共3页
Zhejiang Clinical Medical Journal
关键词
哺乳妇女
骨代谢
骨密度
婴儿
生长发育
Lactating women
Bone metabolism
Bone density
Infants Growth
