1400例正常儿童MEWLKL和改良Klein线参考值分析  

Measurement of reference value of maximum epiphyseal width lateral to Klein＇s line and modification of Klein＇s line in 2 800 hips of 1 400 normal children

作　　者：刘振江[1] 严维[1] 

机构地区：[1]中国医科大学附属盛京医院小儿骨科,沈阳110004

出　　处：《国际儿科学杂志》2016年第4期322-325,F0003,共5页International Journal of Pediatrics

摘　　要：目的通过测量正常儿童髋关节正位x线片的双侧股骨头外侧缘距离Klein线的最大垂直宽度（maximum epiphyseal width lateral to Klein＇s line ,MEWLKL）、双侧MEWLKL差值即改良Klein线，研究MEWLKL和改良Klein线与性别和侧别之间的关系及其随年龄变化的规律，并证实以改良Klein线大于2mm诊断股骨头骨骺滑脱的可靠性。方法回顾性分析我院2005年1月1日至2014年12月31日全部0—14岁患儿的骨盆正位片共14837例，选取其中正常儿童的骨盆正位片共7147例纳入本研究的统计分析。制定正常髋关节X线片的纳入标准。按年龄1—14岁共分14组。每组随机抽取100例，男女各50例，共1400例骨盆正位片，包括2800个髋关节。采用AutoCAD2007软件对MEWLKL和改良Klein线的参考值进行测量，并进行正态分布检验。根据各年龄组的MEWLKL和改良Klein线的参考值，绘制二者随年龄的变化曲线。每个年龄组内MEWLKL的性别和侧别差异采用两个独立样本t检验。年龄组间改良Klein线差异和MEWLKL差异采用单因素方差分析。结果MEWLKL和改良Klein线参考值均符合正态分布。MEWLKL平均参考值为（5．20±1．92）mm，男性平均（5．04±1．88）mm，女性平均（5．36±1．94）mm（P=0．000）；左侧平均（5．06±1．87）mm，右侧平均（5．33±1．96）mm（P=0．000）。MEWLKL在各年龄组总体参考值、男性组和女性组参考值三者的变化趋势相似，均随年龄的增长而逐渐增大。0～4岁逐渐上升，5岁时处于波谷[总体（3．77±1．00）mm，男性组（3．53±1．00）mm，女性组（4．01±0．94）mm]；5岁以后又逐渐上升，13岁时达到峰值[总体（7．49±1．43）mm，女性组（7．84±1．42）mm，男性组在14岁达到峰值（7．24±1．46）mm]。各年龄组总体参考值和女性组参考值在14岁后略有下降。女性组在11岁至12岁又出现第二个波谷（6．44±1．86）mm～（6．38±1．15）mm。双侧MObjective To investigate the maximum epiphyseal width lateral to Klein＇ s line （MEWLKL） and modification of Klein＇s Line （namely difference value of bilateral MEWLKL） on hip plain radiographs of normal children, and to investigate the relationship between MEWLKL and modification of Klein＇s Line and gender and body side, respectively. Methods Anteroposterior （AP） view pelvic plain radi- ographs of fourteen thousand eight hundred and thirty-seven cases aged from zero to fourteen years old in Shengjing Hospital of China Medical University from 2005 January to 2014 December were reviewed. Seven thousand one hundred and forty-seven normal AP pelvic plain radiographs were included in the present study. Fourteen groups based on the age from one years old to fourteen years old were divided. One hundred cases in each age group, including fifty males and fifty females, were randomly selected. Fourteen hundred AP view pelvic plain radiographs including twenty eight hundred hips were measured. The reference value of MEWLKL and modification of Klein＇s line were measured using AutoCAD2007 software, the Normal distribution test were performed using Excel and SPSS19. 0 software. The relationship curve between MEWLKL and modification of Klein＇s Line and age were drawed. The intra-group difference between MEWLKL and gender and body side were performed using t-test in normal children. The inter-group difference between modification of Klein＇s line and average MEWLKL were performed using one-way analysis of variance in normal children. Results The reference value of MEWLKL and modification of Klein＇s Line were both normal distribution. Average reference value of MEWLKL were （5.20 ± 1.92） mm, （5.04 ± 1.88） mm in male, and （5.36 ± 1.94 ） mm in female （P= 0.000）, （5.06±1.87） mm on the left side, and （5.33±1.96） mm on the right side （P= 0. 000）. The curve of reference value of MEWLKL in fourteen general groups were similar to those of fourteen male groups and fourteen female gro

关 键 词：儿童 正常髋关节 X线片 Klein线 股骨头骨骺滑脱 

分 类 号：R816.92[医药卫生—放射医学] R726.8[医药卫生—临床医学]