佝偻病（英文课件）

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1、RicketsofVitaminDDeficiencyTheSecondAffiliatedHospitalofShantouUniversityMedicalCollegeMaLianReviewRickets：signifyingafailureininernalizationofgrowingboneorosteoidtissue.Failureofmaturebonetomineralizeiscalledosteomalacia.EtiologyInadequatedirectexposuretoultravioletraysinsunlightInadequateintak

2、eofvitD(dietmaycontainlittlevitD)GrowthdrugDisease:hepaticandrenallesions、celiacdisease、steatorrheaorcysticfibrosisOrbothAboutVitamin-DTwoforms:vitD2/vitD3vitD2:mostasirradiatedergosterol,largelyreplacedthefishliveroilsassourcevitD3:availableinhumanskinas7-dehydrocholesterol.botharehydroxylatedin

3、theliverto25－(OH)2Dintherenalto1.25－(OH)2D:facilitatecalciumandphosphorusabsorptedPathologytheepiphysealplateofmetaphysisiswelldemonstrated.ThecartilagecellisorderlyThecalcifiedmatrixformstheepiphysealplateisregularThedegeneratingcartilage,islandsofcapillaries,osteoblasts,andunmineralizedosteoidc

4、omposeofbroad,irregular,rachiticimtermediatezoneChemicalpathologycanbeconceptualizedtobethebody’sattempttomaintainnormalserumcalciumlevels.WhencalciumislessparathormoneissecretedincreasethecalciumandphosphorusconcentrationAlkalinephosphatase(ALP).(normallevel≦200IU/dL)canbe500UI/dL.Butmaybenorm

5、alininfantswhohavericketsandwhoareproteinorzincdepleted.aminoaciduria,adecreaseofcitrate,anditsincreasedurinaryexcretion,decreasedabilityofthekidneystomakeanacidurine,phosphaturia,andoccasionally,mellituria.TheparathyroidglandshypertrophyClinicalmanifestationsEarlysigns:Increasedsweating,particul

6、arlyaroundthehead,whichresultintheoccipitalbonebareClinicalmanifestationsAdvancedrickets:Head:earlysignsiscraniotabes,Likeaderbyhatorpingpongball.Thorax:rachiticrosaryHarrison’sgroovePigenbreastdeformitychildrenarelateinstandingandwalkingThedeformitiesofthelongbones:knobbingandprominenceoftheepip

7、hysesOthermanifestations:Teeth-eruptingmaybedelayed,theenamelandextensiveariesaredefected.MuscletoneispoorRoentgenographicfindingsDiagnosisThediagnosisisbasedon:ahistoryofinadeuateintakeofvitaminDandonclinicalobservati