不同病因矮身材儿童TW2-R、C、T骨龄评分特征研究  

Characteristics of R bone age, C bone age, and T bone age in children with different causes of short stature based on Tanner and Whitehouse skeletal age assessment system 2

作　　者：崔蕴璞[1] 张铭涛[1] 王新利[1] 

机构地区：[1]北京大学第三医院儿科,北京100191

出　　处：《中国当代儿科杂志》2015年第5期464-468,共5页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨不同病因矮身材儿童TW2-R、C、T骨龄评分特征,为矮身材的病因诊断提供参考。方法以363例未经治疗的矮身材儿童为研究对象,根据病因分为4组:生长激素缺乏症(GHD,27例)、特发性矮小(ISS,280例)、小于胎龄儿(SGA,41例)、Turner综合征(TS,15例)。拍摄左手腕骨骨龄片,应用TW-2骨龄评分法对各组患儿R骨龄、C骨龄及T骨龄进行评分,将各序列骨龄与年龄对比分析。结果 GHD组男、女儿童表现为R骨龄、C骨龄及T骨龄均较年龄落后2岁以上。ISS组男童R骨龄、C骨龄及T骨龄较年龄落后约1岁;ISS组女童各序列骨龄与年龄比较无显著差异。SGA组男女儿童各序列骨龄与年龄比较无显著差异。TS组R骨龄及T骨龄较年龄显著落后,C骨龄与年龄比较无显著差异。结论不同病因所致的矮身材儿童具有不同的TW-2R、C、T各序列骨龄特点。TW-2R、C、T各序列骨龄的评估对于矮身材儿童病因的诊断具有辅助作用。ObjectiveTo study the characteristics of R bone age, C bone age, and T bone age in children with different causes of short stature based on the Tanner and Whitehouse skeletal age assessment system 2 （TW2）, and to provide a reference for the etiological diagnosis of short stature.MethodsThree hundred and sixty-three children with previously untreated short stature were classiifed into four groups according to the causes： growth hormone deifciency （GHD; 27 cases）, idiopathic short stature （ISS; 280 cases）, small for gestational age （SGA; 41 cases）, and Turner syndrome （TS; 15 cases）. The X-ray iflms of their left hand-wrist bones were taken to determine the bone age. R bone age, C bone age, and T bone age were assessed by the TW2 method and compared with their chronological age （CA）. ResultsR bone age, C bone age, and T bone age were over 2 years less than CA in both boys and girls from the GHD group. In the ISS group, R bone age, C bone age, and T bone age were about 1 year less than CA in boys, while there were no significant differences between the bone ages and CA in girls. In the SGA group, there were no significant differences between the bone ages and CA in either boys or girls. In the TS group, R bone age and T bone age were signiifcantly lower than CA, while there was no signiifcant difference between C bone age and CA.ConclusionsThe children with different causes of short stature have different characteristics of R bone age, C bone age, and T bone age assessed by the TW2 method. The assessment of R bone age, C bone age, and T bone age by the TW2 method is helpful for the etiological diagnosis of short stature in children.

关 键 词：骨龄评估 生长激素缺乏症 特发性矮小 小于胎龄儿 TURNER综合征 儿童 

分 类 号：R725.8[医药卫生—儿科]