正常小児および先天性胆道閉鎖症患児における骨塩の変動に関する臨床的研究

抄録

Bone mineral content (BMC) and bone width (BW) of the radius were measured by photon absorptiometry in 120 children from neonate to 14-year-old and 10 patients with congenital biliary atresia (CBA) living more than 3 years after operation. Though the BMC and the BMC/BW values were well correlated with aging, the BMC/BW value was more appropriate than the BMC value as an index of bone mineralization. Some parameters which were obtained from microdensitometry with X-ray films of the metacarpal bone in 43 normal children were also correlated with aging and the BMC/BW values measured by photon absorptiometry. Ten patients with CBA were classified into 2 groups according to their postoperative clinical courses. The group A included 5 patients who had neither jaundice nor portal hypertension, while the groug B included 5 patients with various degree of liver dysfunction, hepatosplenomegaly and portal hypertention. The BMC/BW values in the both groups were distributed within normal range and the values in the group A were increasing with aging as well as in normal children, while in the group B such increases of the BMC/BW values associated with aging were not found, but only slight increases or even gradual decreases were often found. BM-Age was calculated from a measured BMC/BW value in a patient with CBA and the regression equation between the BMC/BM and age in normal children. Age Difference (A.D.) between the BM-Age and the chronological age was a useful indicator for evaluating bone mineralization in postoperative patientss with CBA. Especially changes of the A.D. assorciated with aging had a good relationship with the postoperative courses and the average values of the A.D. in the group B indicated a significant retardation in bone mineralization compared to the group A. Serum 25-OH-vitamin D and calcium also correlated with the changes of A.D. and postoperative courses of the patients with CBA.