上海交通大学：《儿科学》课程PPT教学课件（讲稿，双语版）第三讲 维生素D缺乏性佝偻病

Rickets of Vitamin D Deficiency 维生素D缺乏性佝偻病

Rickets of Vitamin D Deficiency 维生素D缺乏性佝偻病

Definition Rickets is the term signifying a failure in mineralization of growing bone or osteoid tissue

Definition Rickets is the term signifying a failure in mineralization of growing bone or osteoid tissue

Etiology Inadequate exposure in sunlight 296 310mm 7-dehydrocholesterol VitD3 ultraviolet rays Prevalence Spring> Autum City> Countryside Dark skin> white skin

Etiology 296— 310nm ultraviolet rays Inadequate exposure in sunlight Prevalence Spring > Autum City > Countryside Dark skin > White skin 7-dehydrocholesterol VitD3

Etiology Insufficient intake of vitD3 Insufficient intake of calcium absoption VitD lactose Amino acid inhibition fibers vegetable P↑

Etiology ❖Insufficient intake of VitD3 ❖Insufficient intake of calcium absoption inhibition VitD lactose Amino acid P↑ fibers vegetable

Etiology Rapid growth Low- birth weight infants Adolescents

Etiology adolescents Rapid growth Low- birth weight infants Adolescents

Etiology Diseases Celiac disease Cystic disease Anticonvulsant therapy phenobarbital

Etiology Diseases Celiac disease Anticonvulsant therapy Cystic disease phenobarbital

Etiology Other Nutritional status of mother S Eating habit Feeding pattern Protel Nutrients deficiency Vitc Zn

Etiology Other s Nutritional status of mother Eating habit Nutrients deficiency Zn VitC Protei n Feeding pattern

Pathology Activation of 1,25(OH)2D 25(OH)D3 VitD3 7-脱氢胆固醇

Pathology7 Activation of VitD VitD3 25(OH)D3 1,25(OH)2D3 7-脱氢胆固醇

Pathology Demineralization 1,25(OH)2D3 Osteomalacia a Ca P absorption I deformit Ca×Pl Parathyroid↑ calcium(±)&P↓

Pathology Resume Ca 1,25(OH)2D3↓ Ca ＆ P absorption ↓ Parathiroid ↑ calcium (±) ＆ P ↓ Ca ×P↓ Demineralization Osteomalaci a deformity

Clinical manifestation-skeleton Skull 6 mon craniomalacia(颅骨软化) 6-12 mon cephalus quadratum(方颅) 令 Large anterior fontanel(囟门大) 今 Teeth eruption delay(出牙迟)

Clinical manifestation-skeleton Skull ❖<6mon craniomalacia (颅骨软化) ❖6-12mon cephalus quadratum (方颅) ❖Large anterior fontanel (囟门大) ❖Teeth eruption delay (出牙迟)