中国人手腕骨发育标准—中华05.III.中国儿童骨发育的长期趋势

The Standards of Skeletal Maturity of Hand and Wrist for Chinese-China 05. III. The Secular Trend of Skeletal Development in Chinese Children

目的：观察中国儿童骨发育的长期趋势，为合理应用我国不同时期的骨发育标准提供参考。方法：以1988年、2005年骨发育调查样本为对象。以概率单位回归方法计算各样本儿童的手腕骨化中心出现年龄和融合年龄。以CHN法评价2005年样本儿童各年龄组的骨龄，并与生活年龄比较。结果：与1964年的儿童相比，1988年儿童手腕骨化中心出现年龄和融合年龄均提前；而与1988年样本比较，2005年男女儿童掌指骨骨化中心出现年龄均提前0．5岁～1．0岁，掌指骨的骺干融合年龄分别提前1．0岁和1．0-1．5岁；2005年不同年龄组男女儿童的CHN骨龄分别提前0．3岁～1．1岁和0．2岁～1．0岁。结论：近40年来，中国儿童骨发育表现出加速的长期趋势，应当慎用1964年和1988年骨龄标准评价当代中国儿童的骨发育状况。

Objective Due to the accelerated growth of Chinese children, the secular trend of accelerated skeletal development was observed in this study in order to provide the evidence for using the standards of skeletal maturity in reason. Methods The subjects were the children from two skeletal development surveys in 1980s and 2000s. The appearance age and fusion age of ossification centers in hand and wrist were calculated using the probit regression analysis, and the skeletal ages of children from the survey in 2000s were estimated by CHN method. The CHN skeletal ages were compared with calendar ages. Results Compared with the children in 1960s, the appearance ages and fusion ages of the ossification centers were all advanced in children in 1980s. Compared with the children in 1980s, the metacarpals and phalanges of children in 2000s were advanced by 0.5 - 1.0 year at age of appearance of ossification centers and 1.0 year in boys and 1.0 - 1.5 years in girls at the ages of fusion ossification centers. The ages of complete ossification of radius and ulna in children in 2000s were advanced by 0.4 year in boys and 0.3 year in girls. The differences between CHN skeletal age and chronological age of all age groups in 2000s were 0.3 - 1.1 year in boys and 0.2 - 1.0 year in girls. Conclusions In the last 40 years, the secular trend of accelerated skeletal development was presented in Chinese children. It should be cautious to estimate the contemporary Chinese children when using the skeletal norms of 1960s or 1980s.