中国临床营养网（lcyycc）
CasestudyNo.39
文/亚太临床营养杂志（中文版）
摘自：亚太临床营养杂志中文版订阅号（APJCN-in-China）
Afemaleinfantof9monthswastakentotheclinicbyhermotherwithpainoverthelowerextremitiesandlimitationofmovementsformorethan10days.Thelegswerekeptinthe“frogleg”positionandwereapparentlyverytender.
Thebabyhadbeenartificiallyfedwithmilkpowder,biscuitandpastemadeofwheatfloursincebirth,hadneverreceiverfreshfruit,vegetablesorfruitjuice.Foronemonthbeforethepresentillness,theinfanthadbeenlistless,tendedtocryandwasanorexic.X-rayexaminationofthelowerextremitiesshoweda“ground–glass”appearanceoftheboneswiththinningofcortex,athickwhitelineatthemetaphysicandaperipheralmetaphysealcleft,thesocalledcornersign,wereseen.Subperiostealhaemorrhagewasnoticed.
ThepatientwastreatedwithlargedosesofvitaminC.Legpainwasrelievedwithin2days,thelowerextremitiesweremovedspontaneouslyandtendernessandswellingofthelegslessened.
Whichofthefollowingstatementarecorrect?
A.Infantilescurvycanoccurasofteninbreast-fedasinbottle–fedbabies.
B.SubperiostealhaemorrhageofvitaminCdeficiencyisduetothedefectivecollagenformationinthebasementmembranesofcapillaries.
C.Thelowplasmaascorbateconcentrationisadiagnosticfindingofscurvy.
一名9个月大的女婴由于整个下肢疼痛且活动受限超过10天被她的母亲带到诊所，腿部呈“青蛙腿式”姿势，明显无力。
该患儿从出生开始进行人工喂养，包括牛奶、或者由小麦粉做的点心和糕团，从未吃过新鲜水果，蔬菜或果汁，在患病前的一个月，患儿精神倦怠，易哭且厌食。X光检查下肢骨骼呈磨玻璃影、伴皮层变薄，骨骺端有较密的白线，且外围骨骺端有裂缝。可以看见“鸟嘴征”，检查出骨膜下出血。
患儿接受大剂量的维生素C治疗，2天内腿痛缓解，下肢可自主运动且腿部无力感和肿胀有所减轻。
A．母乳喂养与人工喂养的婴儿患婴幼儿坏血症的几率是一样的
B．维生素C缺乏导致的骨膜下出血是由于毛细血管基底膜的胶原蛋白形成缺乏
C．血浆低浓度抗坏血酸盐可作为诊断坏血症的依据
CorrectanswerB
Mostanimalssynthesizeascorbatefromglucoseviaglucuronicacidandgulonicacid.Howeverman,otherprimates,theguinea-pigandotherspeciesareknowntorelyonadietarysourceofvitaminC.
大多数动物从葡萄糖经葡萄糖醛酸和古洛糖酸途径合成抗坏血酸。然而人类和其他灵长类动物、豚鼠及其他物种是依赖于饮食来源获取维生素C
AlthoughvitaminCisarelativelysimple北京治疗白癜风有哪些方法有地方能治好白癜风吗