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三种方法评估藏族儿童骨龄效果比较及藏族儿童骨龄发育特点

次旦旺久 拉巴顿珠 王凤丹 顾潇 陈适 刘永亮 石磊 潘慧 银武 金征宇

次旦旺久, 拉巴顿珠, 王凤丹, 顾潇, 陈适, 刘永亮, 石磊, 潘慧, 银武, 金征宇. 三种方法评估藏族儿童骨龄效果比较及藏族儿童骨龄发育特点[J]. 协和医学杂志, 2021, 12(3): 411-416. doi: 10.12290/xhyxzz.20200259
引用本文: 次旦旺久, 拉巴顿珠, 王凤丹, 顾潇, 陈适, 刘永亮, 石磊, 潘慧, 银武, 金征宇. 三种方法评估藏族儿童骨龄效果比较及藏族儿童骨龄发育特点[J]. 协和医学杂志, 2021, 12(3): 411-416. doi: 10.12290/xhyxzz.20200259
CIDAN Wangjiu, LABA Dunzhu, WANG Fengdan, GU Xiao, CHEN Shi, LIU Yongliang, SHI Lei, PAN Hui, YIN Wu, JIN Zhengyu. Comparison of Three Methods of Assessing the Bone Age in Tibetan Children and the Features of Their Skeletal Maturity[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(3): 411-416. doi: 10.12290/xhyxzz.20200259
Citation: CIDAN Wangjiu, LABA Dunzhu, WANG Fengdan, GU Xiao, CHEN Shi, LIU Yongliang, SHI Lei, PAN Hui, YIN Wu, JIN Zhengyu. Comparison of Three Methods of Assessing the Bone Age in Tibetan Children and the Features of Their Skeletal Maturity[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(3): 411-416. doi: 10.12290/xhyxzz.20200259

三种方法评估藏族儿童骨龄效果比较及藏族儿童骨龄发育特点

doi: 10.12290/xhyxzz.20200259
基金项目: 

国家自然科学基金青年科学基金项目 82001900

西藏自治区自然科学基金组团式援藏医学项目 XZ2020ZR-ZY01(Z)

详细信息
    通讯作者:

    王凤丹 电话:010-69159608,E-mail:wangfengdan@pumch.cn

  • 中图分类号: R725.8

Comparison of Three Methods of Assessing the Bone Age in Tibetan Children and the Features of Their Skeletal Maturity

Funds: 

the Youth Fund of National Natural Science Foundation of China 82001900

the Group Aiding Medical Program of Natural Science Foundation of Tibet XZ2020ZR-ZY01(Z)

More Information
  • 摘要:   目的  探讨更适用于藏族儿童的骨龄测定方法,并进一步总结藏族儿童的骨龄发育规律。  方法  回顾性收集2013年9月至2019年11月因外伤就诊于西藏自治区人民医院的4~18岁藏族儿童临床资料。研究对象均拍摄左手腕部X线片作为骨龄片。北京协和医院2名医生依据Greulich-Pyle(GP)图谱法共同阅片,得出GP图谱法骨龄。由人工智能骨龄系统自动阅片完成Tanner-Whitehouse3(TW3)法(包括TW3-RUS法和TW3-Carpal法)和中国人手腕骨发育标准-中华05.Ⅳ. (中华05)法骨龄测定。采用Pearson相关法分析GP图谱、TW3法、中华05法测定的骨龄与日历年龄的相关性。  结果  共305例符合纳入和排除标准的藏族儿童入选本研究。其中男童209例,女童96例;平均日历年龄(11.22±4.81)岁。Pearson相关法分析显示,GP图谱法、TW3-RUS法、TW3-Carpal法及中华05法测定的骨龄与藏族儿童日历年龄均高度相关,其中以GP图谱法的相关性最强(r=0.961),其次为TW3-RUS法(r=0.941)、中华05法(r=0.937)、TW3-Carpal法(r=0.895)。藏族儿童普遍存在发育延缓;4~10岁儿童的骨龄不同程度地小于日历年龄;青春发育期(11~15岁)儿童的骨龄超过日历年龄(13岁男童除外),呈追赶趋势,但16~18岁时的骨龄仍小于日历年龄。  结论  与TW3法、中华05法相比,GP图谱法更适用于藏族儿童的骨龄评估;藏族儿童的骨龄发育呈青春发育期追赶的趋势,但整体仍落后于日历年龄。
    编者按:
    援藏援疆是国家战略,是推动边疆发展稳定、促进各民族大团结的重大举措。为推动西藏自治区、新疆维吾尔自治区医疗卫生事业的发展,“十三五”期间,国家卫生健康委员会大力推进以医疗人才“组团式”援藏援疆为主要代表的卫生健康对口帮扶工作,将先进的诊疗技术和优秀的管理理念进行深入移植,全面提升了当地的医疗卫生服务水平。
    一直以来,医疗人才“组团式”援藏援疆工作稳步推进,精准施策,在提升当地医疗服务水平的同时,也开展了相对开创性的医学研究,积累了诸多宝贵经验。为此,我刊特别开设“援藏援疆专栏”,记录和发布援藏援疆系列宝贵经验和研究成果,以期为推动援藏援疆事业发展作出更大贡献。
    编者按:
    作者贡献:王凤丹、潘慧、银武、金征宇提出研究设计思路;次旦旺久、拉巴顿珠、王凤丹、顾潇、陈适、刘永亮、石磊进行数据整理和分析;次旦旺久、王凤丹完成文章初稿;所有作者均参与论文修改。
    编者按:
    利益冲突  无
  • 图  1  305例藏族儿童日历年龄分布条形图

    图  2  藏族儿童各年龄段骨龄发育情况

    表  1  不同方法测定的骨龄结果与日历年龄的相关性分析

    评估方法 骨龄(x±s,岁) r
    总体(n=305)
      GP图谱法 10.64±5.18 0.961
      TW3-RUS法 10.26±4.90 0.941
      TW3-Carpal法 9.12±3.53 0.895
      中华05法 10.46±4.41 0.937
    男童(n=209)
      GP图谱法 11.00±5.26 0.958
      TW3-RUS法 10.70±4.94 0.942
      TW3-Carpal法 9.62±3.66 0.909
      中华05法 10.88±4.43 0.938
    女童(n=96)
      GP图谱法 9.85±4.95 0.968
      TW3-RUS法 9.28±4.68 0.937
      TW3-Carpal法 8.05±2.99 0.879
      中华05法 9.53±4.23 0.935
    下载: 导出CSV

    表  2  不同年龄段藏族儿童GP图谱法骨龄与日历年龄的差值分布(x±s,岁)

    CA
    (岁)
    男童(n=209) 女童(n=96)
    例数(n) CA BA BA-CA P 例数(n) CA BA BA-CA P
    4 20 4.10±0.23 3.64±0.51 -0.96±1.19 0.002 12 4.05±0.08 3.46±0.73 -0.59±0.76 0.021
    5 12 5.09±0.22 4.18±0.69 -1.71±1.32 0.001 7 5.13±0.34 4.56±0.64 -0.57±0.53 0.028
    6 16 6.25±0.38 4.94±0.89 -1.31±0.97 0.000 9 6.01±0.03 5.02±1.08 -0.99±1.08 0.025
    7 10 7.11±0.21 5.36±1.14 -1.75±1.17 0.001 5 7.14±0.13 5.68±2.04 -1.46±2.12 0.198
    8 13 8.21±0.30 7.06±1.63 -1.15±1.61 0.025 8 8.10±0.24 7.38±1.10 -0.73±1.02 0.084
    9 9 9.04±1.33 8.56±1.93 -0.49±1.89 0.461 3 9.27±0.31 8.53±1.37 -0.73±1.55 0.499
    10 13 10.08±0.22 9.10±1.72 -0.99±1.62 0.049 6 10.12±0.16 9.40±1.73 -0.72±1.66 0.337
    11 8 11.18±0.31 11.50±1.63 0.62±2.97 0.543 4 11.10±0.20 11.33±1.97 0.23±1.94 0.831
    12 12 12.14±0.25 12.54±1.97 0.40±1.95 0.492 5 12.08±0.18 10.92±1.68 -1.22±3.45 0.169
    13 9 12.28±0.34 12.17±1.41 -1.11±1.42 0.047 5 13.34±0.27 13.80±0.76 0.46±0.50 0.110
    14 16 14.21±0.33 14.77±2.12 0.56±1.97 0.272 4 14.30±0.35 14.70±1.33 0.40±1.11 0.524
    15 12 15.23±0.32 16.06±1.48 0.83±1.44 0.086 6 15.29±0.24 15.08±1.16 0.28±2.71 0.737
    16 16 16.21±0.30 16.06±0.96 -0.14±1.00 0.572 9 16.01±0.04 15.35±1.23 -0.66±1.26 0.180
    17 20 17.11±0.23 16.52±1.10 -0.59±1.05 0.022 6 17.28±0.30 15.67±1.17 -1.62±1.23 0.023
    18 22 18.31±0.36 17.36±1.62 -0.96±1.67 0.014 6 18.17±0.29 17.17±0.98 -1.96±2.44 0.044
    CA:日历年龄; BA:骨龄
    下载: 导出CSV
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出版历程
  • 收稿日期:  2020-09-29
  • 录用日期:  2020-11-24
  • 刊出日期:  2021-05-30

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