全国3~18岁正常儿童骨发育成熟度大样本现况调查的抽样设计和X线影像采集方案  

Sampling study design and radiography protocol of a large-sample investigation on skeletal maturation in 3 to 18-year-old children in China

作　　者：李凯[1] 甘倩 耿健 马毅民[1] 王文海[1] 刘艳东 张倩 杨振宇 赵文华 闫东[1] 程晓光[1] Li Kai;Gan Qian;Geng Jian;Ma Yimin;Wang Wenhai;Liu Yandong;Zhang Qian;Yang Zhenyu;Zhao Wenhua;Yan Dong;Cheng Xiaoguang(Department of Radiology,Beijing Jishuitan Hospital,Beijing 100035,China;National Institute for Nutrition and Health,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]北京积水潭医院放射科,北京100035 [2]中国疾病预防控制中心营养与健康所,北京100050

出　　处：《中华放射学杂志》2023年第4期348-352,共5页Chinese Journal of Radiology

基　　金：科技部基础资源调查专项(2017FY101100);北京市医院管理中心临床医学发展专项(ZYLX202107);北京积水潭医院高层次人才学科骨干培养计划(XKGG202122)。

摘　　要：目的报道全国3~18岁正常儿童骨发育成熟度大样本现状调查的抽样设计、X线影像采集方案和实施情况。方法采用多阶段分层随机抽样,在全国东北、西北、华北、华中、华东、西南和华南7个区域分别随机选择2个省、直辖市或自治区,再从中随机选取城市和乡村各1个调查点,共计28个调查点。每个城市调查点抽取4个街道,每个农村调查点抽取4个乡镇。于每个街道或乡镇抽取1~4所幼儿园、小学和中学,采用随机整群抽样的方法在幼儿园抽取3~<6岁儿童,在小学、中学抽取6~18岁儿童。在项目整体抽样的基础上按比例抽样进行骨成熟度调查,计划每个调查点780例,预计总样本量21840例。3~<6岁儿童按0.5岁间隔分为6个年龄组,6~18岁儿童按1岁间隔分为12个年龄组。统一采集儿童左手腕骨的正位X线片。结果采样工作自2019年8月26日开始,到2021年10月16日结束。共计采集20444例儿童手腕骨的正位X线片,男10196例、女10248例,城市儿童9711例、农村儿童10733例。3~<6岁1611例,男819例、女792例;6~18岁18833例,男9377例、女9456例。结论在全国范围内7个区域成功实施了3~18岁正常儿童青少年骨发育成熟度的现况调查,为建立现阶段全国儿童青少年骨龄的评价标准提供重要参考依据。Objective To report the sampling study design and radiography protocol of a large-sample investigation on skeletal maturation of 3 to 18-year-old children in China.Methods Multi-stage stratified random sampling was employed in this study.Two provinces,municipalities,or autonomous regions were randomly selected from each of the seven regions of China,including Northeast China,Northwest China,North China,Central China,East China,Southwest China,and South China.Then one rural and one urban investigation site were randomly selected from each province,municipality,or autonomous region.In total 28 sites were included.Among those sites,four residential districts were randomly selected from each urban site,and four townships from each rural site.For each residential district or township,1-4 kindergartens,primary schools,and middle schools were chosen.Random cluster sampling was used to extract 3-<6-year-old children in kindergartens,and 6-18-year-old children in primary schools and middle schools.The investigation on skeletal maturation was sampled proportionate to the sampling of the whole study.The estimated simple size was 780 for each site,and 21840 for all 28 sites in total.There were six groups of 3-<6-year-old children classified at 0.5-year intervals,and 12 groups of 6-18-year-old children classified at 1-year intervals.Posteroanterior position radiography of the left hand and wrist was achieved for all subjects.Results The study was performed from August 26,2019 to October 16,2021.In total,20444 children received posteroanterior position radiography of the left hand and wrist,including 10196 males and 10248 females,9711 urban and 10733 rural,respectively.The 3-<6-year-old group included 1611(male 819,female 792)subjects,and the 6 to 18-year-old group included 18833(male 9377,female 9456)subjects.Conclusion This nationwide investigation on skeletal maturation of 3 to 18-year-old children in seven regions of China was successfully preformed.The results of this study can provide an important reference for establish

关 键 词：儿童 年龄测定 骨骼 X线 

分 类 号：R179[医药卫生—妇幼卫生保健]