【摘要】：目的評價Greulich-Pyle圖譜法(GP)、中國人手腕骨發(fā)育標(biāo)準(zhǔn)-CHN法(CHN)和中國人手腕標(biāo)準(zhǔn)-中華05法(TW3-C RUS)測得的骨齡是否會影響臨床醫(yī)生對兒童骨成熟水平的判斷。方法納入因身材矮小或提前發(fā)育或懷疑生長發(fā)育問題有必要行X線片評估的3~17歲兒童左手正位X線骨齡片。排除患遺傳代謝性、骨軟骨發(fā)育障礙性疾病的兒童,排除接受過生長激素等治療的兒童。1名經(jīng)過骨齡片評估培訓(xùn)的研究生依序?qū)γ繌圶線骨齡片用上述3種方法分別評價,采用Bland-Altman法構(gòu)建一致性限。結(jié)果 567例左手正位X線片進(jìn)入分析,男童269例,女童298例,男、女童各分3~4、~6、~8、~10、~12、~14和~17年齡組,每組17~78例。男103例和女142例達(dá)到青春期發(fā)育標(biāo)準(zhǔn)。男、女童所有年齡組測得的骨齡CHN法GP法和TW3-C RUS法;男、女童中除3個年齡組外,余11個年齡組測得骨齡TW3-C RUS法均GP法。男、女童的所有年齡組3種方法評價的最大骨齡與最小骨齡的差值隨年齡增加而增大。鑒于TW3-C RUS評價男童最大骨齡為16歲,女童最大骨齡為15歲,去除TW3-C RUS法男童≥16歲(18例)和女童≥15歲(34例)的骨齡片,515例左手正位的X線片(男251例,女264例)進(jìn)入3種方法一致性限分析。男童3~4歲骨齡和~6歲骨齡TW3-C RUS法與GP法一致性良好,女童3~4歲骨齡CHN法與TW3-C RUS法、~8歲骨齡TW3-C RUS法與GP法一致性良好,女童未發(fā)育組TW3-C RUS法與GP法一致性良好,余男、女童不同骨齡和發(fā)育情況3種骨齡測量法一致性差。結(jié)論 3種骨齡測量方法得出的骨齡結(jié)果不能相互替代,臨床應(yīng)用時應(yīng)明確骨齡測評的方法。
[Abstract]:Objective to evaluate whether the bone age measured by Greulich-Pyle map method (GP), Chinese wrist bone development standard -CHN method (CHN) and Chinese wrist standard Zhonghua 05 method (TW3-C RUS) will affect the judgment of children's bone maturity by clinicians. Methods X-ray radiographs of the left hand orthostatic bone age of children aged 3 to 17 years were included for short stature or early development or suspected growth and development. Excluding children with genetic metabolic and osteochondral dysplasia, and excluding children treated with growth hormone, 1 graduate students trained in bone age assessment were evaluated by the three methods mentioned above. The consistency limit was constructed by Bland-Altman method. Results 567 cases of left hand radiographs entered the analysis, 269 boys, 298 girls, boys and girls were divided into 3 groups, each with 1778 cases. 103 males and 142 females reached the standard of puberty development. Bone age CHN method and TW3-C RUS method were used in all age groups of male and girl, except 3 age groups, TW3-C RUS method of bone age were all detected by GP method in the other 11 age groups of male and female. The difference between the maximum bone age and the minimum bone age in all age groups of male and female increased with the increase of age. Whereas the maximum bone age of boys was 16 years old and that of girls was 15 years old by TW3-C RUS, 515 cases (male 251 cases) of left hand positive position were examined with bone age films of boys 鈮，

本文編號：2178142