三种骨龄评价方法在3～17岁儿童临床应用中的一致性比较研究
发布时间：2018-08-11 20:22
【摘要】：目的评价Greulich-Pyle图谱法(GP)、中国人手腕骨发育标准-CHN法(CHN)和中国人手腕标准-中华05法(TW3-C RUS)测得的骨龄是否会影响临床医生对儿童骨成熟水平的判断。方法纳入因身材矮小或提前发育或怀疑生长发育问题有必要行X线片评估的3~17岁儿童左手正位X线骨龄片。排除患遗传代谢性、骨软骨发育障碍性疾病的儿童,排除接受过生长激素等治疗的儿童。1名经过骨龄片评估培训的研究生依序对每张X线骨龄片用上述3种方法分别评价,采用Bland-Altman法构建一致性限。结果 567例左手正位X线片进入分析,男童269例,女童298例,男、女童各分3~4、~6、~8、~10、~12、~14和~17年龄组,每组17~78例。男103例和女142例达到青春期发育标准。男、女童所有年龄组测得的骨龄CHN法GP法和TW3-C RUS法;男、女童中除3个年龄组外,余11个年龄组测得骨龄TW3-C RUS法均GP法。男、女童的所有年龄组3种方法评价的最大骨龄与最小骨龄的差值随年龄增加而增大。鉴于TW3-C RUS评价男童最大骨龄为16岁,女童最大骨龄为15岁,去除TW3-C RUS法男童≥16岁(18例)和女童≥15岁(34例)的骨龄片,515例左手正位的X线片(男251例,女264例)进入3种方法一致性限分析。男童3~4岁骨龄和~6岁骨龄TW3-C RUS法与GP法一致性良好,女童3~4岁骨龄CHN法与TW3-C RUS法、~8岁骨龄TW3-C RUS法与GP法一致性良好,女童未发育组TW3-C RUS法与GP法一致性良好,余男、女童不同骨龄和发育情况3种骨龄测量法一致性差。结论 3种骨龄测量方法得出的骨龄结果不能相互替代,临床应用时应明确骨龄测评的方法。
[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，
本文编号：2178142
[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，
本文编号：2178142
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