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題名 | 不同年齡層孩童之血清無機磷值與腎臟磷酸鹽排泄量之研究 |
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作者姓名(中文) | 葉明憲; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 32:5 民80.09-10 |
頁次 | 頁303-313 |
分類號 | 415.139 |
關鍵詞 | 血清; 孩童; 研究; 排泄量; 無機磷值; 腎臟; 磷酸鹽; |
語文 | 中文(Chinese) |
中文摘要 | 爲建立國人各年齡層血清無機磷參考值,觀察國人孩童是否有相似於國外所報告孩童有較高之血清無機磷值,及尋找導致此種高血清無機磷值之相關因素,因而從事以下之研究。研究對象以出生2-3天及出生5-7天之新生兒33人,6-18歲之小學一年級到高中三年級(12年齡層)學生1,094人及成人62人共1,189人測定血清無機磷值作分析;其結果爲同一年齡層之男、女生間並無明顯之差異,但在不同年齡層間以2-3天新生兒血清無機磷值7.20mg/dl,及其在5-7天時之血清無機磷值7.65mg/dl爲最高,6-11歲之男生血清無機磷值5.15-5.50mg/dl,女生血清無機磷值5.14-5.28mg/dl則爲次高者,12-18歲之男生血清無機磷值4.31-4.94mg/dl,女生之血清無機磷值4.44-4.96mg/dl則又次之,在成人男性之血清無機磷值3.34mg/dl,成人女性之血清無機磷值3.76mg/dl則爲最低。即隨年齡之增加,血清無機磷值也隨之降低之結果,同與國外報告以Walton-Bijvoet圖解表延伸法所測得之腎臓磷酸鹽閾值發現;在出生2-3天新生兒之腎臓磷酸鹽閾值爲8.41mg/dl GFR,及其在5-7天時之腎臓磷酸鹽閾值爲7.76mg/dl GFR也爲最高,6-11歲之男性腎臓磷酸鹽閾值爲5.84-6.32mg/dl GFR,女生腎臓磷酸鹽閾值爲5.82-6.20mg/dl GFR則爲次高者,12-18歲之男生腎臓磷酸鹽閾值爲5.54-6.10mg/dl GFR,女生之腎臓磷酸鹽閾值5.44-6.10mg/dl GFR則又次之,在成人男性之腎臓磷酸鹽閾值3.51mg/dl GFR,成人女性之腎臓磷酸鹽閾值3.62mg/dl GFR則也爲最低。各年齡層之血清無機磷值與腎臓磷酸鹽閾值具良好之線性關係(r=0.909),顯示腎臓磷酸鹽閾值是決定血清無機磷值之一重要因素。嬰兒奶粉中之磷攝取量,低腎絲球濾過率(GFR)及低腎臓磷酸鹽廓清率(Cpo4)是影響新生兒高血清無機磷值之重要因素。基於細胞對磷之需求量而使腸道對磷之高吸收能力極可能是除腎臓磷酸鹽閾值外,在發育成長孩童有較高之血清無機磷值的另一相關因素。也正因爲發育中孩童有較高之血清無機磷值存在,使正在成長中之細胞與骨骼快速礦物質化所需之無機磷方得以維持平衡。 |
英文摘要 | To further elucidate the data of high serum phosphorus concentration reported for foreign children this study compared the values of serum phosphorus concentration in ethnic Chinese children with foreigners' results, and investigated the potential causes of high serum phosphorus concentration This study included 33 healthy term male neonates from 2-3 days to 5-7 days old, 1,094 children of 6-18 years old (elementary school-senior high school) and 62 adults. A total of 1,189 persons were studied. Value of serum phosphorus concentration showed no significant difference between boys and girls and no age dependency; there was notable change in serum phosphorus concentration in growing children of different ages. The mean values of serum phosphorus concentration of neonates aged 2-3 days and 5-7 days (7.20 mg/dl and 7.65 mg/dl, respectively) were the highest; boys aged 6-11 years 5.15-5.50 mg/dl and girls aged 6-11 years 5.14-5.28 mg/dl were the second; boys aged 12-18 years 4.31-4.94 mg/dl and girls aged 12-18 years 4.44-4.96 mg/dl were the lowest. These findings are similar to the conclusions of foreign reports that the older the subjects of the study, the less their serum phosphorus concentration. The maximal transport rates of tubular phosphate reabsorption were determined from a Walton-Bijvoet nomogram using the side- rule method they recommend. The renal phosphate threshold concentration of neonates aged 2-3 days 8.41 mg/100 ml GFR and 5-7 days 7.76 mg/dl GFR was also the highest; boys aged 6-11 years 5.84-6.32 mg/dl GFR and girls aged 6-1l years 5.82-6.10 mg/dl GFR and 5.44-6.10 mg/dl GFR was the second; adult males 3.51 mg/dl GFR and adult females 3.62 mg/dl GFR was the lowest. Increased intestinal absorption of phosphorus, low GFR and low clearance of phosphorus might be the contributing factors to cause high serum phosphorus concentration. Although high renal phosphate threshold capacity is important, increased absorption of phosphorus by G-1 tract seems to be another factor in accordance with the need of phosphorus of the growing body cells. |
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