邯郸地区生长发育异常儿童骨龄生长学特征及相关因素研究(1)
摘要：目的 通過对邯郸地区生长发育异常(矮身高)儿童骨龄评价，探索该组儿童的生长发育现状，从而指导临床对生长发育异常儿童的重视和关注，达到早发现、早干预、早治疗等目的。方法 收集邯郸地区2014年1月～2017年12月以生长发育异常(矮身高)而就诊，拍摄手腕部骨龄片1478例，应用CHN骨龄测评方法和G-P图谱法对其骨龄进行评估，根据骨龄判定标准，从而判定矮身高儿童的骨龄现状。结果 ①矮身高儿童的骨龄表现骨龄落后657例，骨龄吻合578例，骨龄提前243例，以骨龄落后为主，男性小于生活年龄(1.38±1.39)岁，女性小于生活年龄(1.25±0.76)岁。②不同原因导致的矮身高骨龄生长学特征不同;③手腕骨不同骨骺，在骨龄落后的程度也不同，在657例骨龄落后病例中，尺骨发育晚或形态落后130例，腕骨数量少或形态落后178例，多个骨骺联合发育落后125例，伴有第二掌骨基底部假骨骺77例，而桡骨远端、掌指骨骨骺发育晚的所占比例较少。结论 ①矮身高儿童的骨龄发育可以表现为骨龄落后、骨龄提前和骨龄吻合，以骨龄落后为主;②不同病因导致的矮身高骨龄生长学特征不同，不健康生活方式、先天条件不足、特发性矮小导致的矮身高，骨龄多落后在2岁以内多见，而病理性矮身高，如生长激素缺乏大部分骨龄落后，多在2岁左右，甲状腺功能低下导致的骨龄落后程度较大，一般在3岁左右，肾脏疾病导致的骨龄情况髓这体内激素分泌的变化而变化，可骨龄落后、也可骨龄提前;而Turner综合征及其他基因遗传性疾病中，骨龄落后程度较小，多在1～2岁;性早熟导致的矮身高，骨龄多提前，偶有骨龄落后的发生。③骨龄落后以腕骨、尺骨出现晚或形态落后、或多个骨骺联合落后为主，但伴有第二掌骨基底部假骨骺也有一定比率，是否能作为判定骨龄落后的标志有待研究。
, 百拇医药
关键词：生长发育异常;矮身高;骨龄测评;骨龄落后程度
中图分类号：R153.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.03.042
文章编号：1006-1959(2019)03-0131-03
Abstract：Objective To explore the growth and development status of children in this group by analyzing the bone age of children with abnormal growth and development (small height)， and to guide the clinical attention that focus on children with abnormal growth and development， to achieve early detection， early intervention， early treatment and so on. Methods From January 2014 to December 2017， children with abnormal growth and development were collected in Handan area. 1478 cases of wrist bone age were taken. The bone age was evaluated by CHN bone age measurement method and GP mapping method. Determine the criteria to determine the age of the bones of children with short stature.Results ①The bone age of short stature children showed 657 cases of bone age， 578 cases of bone age anastomosis， and 243 cases of bone age， mainly due to bone age， males less than the age of life (1.38±1.39) years old， and women less than the age of life (1.25±0.76) years old. ②The growth characteristics of the short bones and bones caused by different reasons were different;③Different bones of the wrist bones were different in the degree of bone age. In 657 cases of bone age backwards， 130 cases had late ulnar development or backward shape， and the number of wrist bones was small or the shape was backward. Of the 178 cases， 125 cases were associated with multiple osteophytes， and 77 cases were associated with the second metacarpal base. The proportion of the distal humerus and metacarpal phalanx was less. Conclusion ①The skeletal age of children with short stature can be expressed as bone age， bone age and bone age， and bone age is the main cause; ②Different causes of short stature and high bone age growth characteristics， unhealthy lifestyle， innate conditions， idiopathic short The resulting short stature， bone age is more than 2 years old， and pathological short height， such as growth hormone deficiency， most of the bones are backward， mostly around 2 years old， the skeletal age caused by hypothyroidism is relatively large， generally 3 years old， the bone age caused by kidney disease changes in the hormone secretion in the marrow， but the bone age is backward， but the bone age is advanced; while in Turner syndrome and other genetic hereditary diseases， the bone age is less， mostly in 1～2 years old; short stature caused by precocious puberty， bone age is advanced， and sometimes bone age is behind.③The bone age is backward. The wrist bone and ulna appear late or the shape is backward， or multiple osteophytes are backward. However， there is also a certain ratio of the pseudocarpar bone at the base of the second metacarpal bone. Whether it can be used as a marker for determining the backwardness of bone age is the goal of further research., 百拇医药(董静娟 董辉)
, 百拇医药
关键词：生长发育异常;矮身高;骨龄测评;骨龄落后程度
中图分类号：R153.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.03.042
文章编号：1006-1959(2019)03-0131-03
Abstract：Objective To explore the growth and development status of children in this group by analyzing the bone age of children with abnormal growth and development (small height)， and to guide the clinical attention that focus on children with abnormal growth and development， to achieve early detection， early intervention， early treatment and so on. Methods From January 2014 to December 2017， children with abnormal growth and development were collected in Handan area. 1478 cases of wrist bone age were taken. The bone age was evaluated by CHN bone age measurement method and GP mapping method. Determine the criteria to determine the age of the bones of children with short stature.Results ①The bone age of short stature children showed 657 cases of bone age， 578 cases of bone age anastomosis， and 243 cases of bone age， mainly due to bone age， males less than the age of life (1.38±1.39) years old， and women less than the age of life (1.25±0.76) years old. ②The growth characteristics of the short bones and bones caused by different reasons were different;③Different bones of the wrist bones were different in the degree of bone age. In 657 cases of bone age backwards， 130 cases had late ulnar development or backward shape， and the number of wrist bones was small or the shape was backward. Of the 178 cases， 125 cases were associated with multiple osteophytes， and 77 cases were associated with the second metacarpal base. The proportion of the distal humerus and metacarpal phalanx was less. Conclusion ①The skeletal age of children with short stature can be expressed as bone age， bone age and bone age， and bone age is the main cause; ②Different causes of short stature and high bone age growth characteristics， unhealthy lifestyle， innate conditions， idiopathic short The resulting short stature， bone age is more than 2 years old， and pathological short height， such as growth hormone deficiency， most of the bones are backward， mostly around 2 years old， the skeletal age caused by hypothyroidism is relatively large， generally 3 years old， the bone age caused by kidney disease changes in the hormone secretion in the marrow， but the bone age is backward， but the bone age is advanced; while in Turner syndrome and other genetic hereditary diseases， the bone age is less， mostly in 1～2 years old; short stature caused by precocious puberty， bone age is advanced， and sometimes bone age is behind.③The bone age is backward. The wrist bone and ulna appear late or the shape is backward， or multiple osteophytes are backward. However， there is also a certain ratio of the pseudocarpar bone at the base of the second metacarpal bone. Whether it can be used as a marker for determining the backwardness of bone age is the goal of further research., 百拇医药(董静娟 董辉)