超声多元计数法对婴儿骨龄测定的价值

The value of ultrsonic multi-count method in the deterimation of infant bone-age determination

目的:探讨超声对婴儿骨龄检查的可行性及多元计数法婴儿骨龄测定的价值。方法:采用5～8MHz探头,扫查309例1岁以内婴儿左侧踝、膝、髋、腕、肘、肩6个关节的标志性骨化中心,其中正常组136例,异常组173例。以标志性骨化中心出现的中位时间为界,计算骨龄系数(标志性骨化中心已出现数/应出现数)和骨龄(实际月龄×骨龄系数)。结果:正常男女组骨龄系数(1.034±0.05;1.066±0.096)与异常男女组骨龄系数(0.888±0.067;0.871±0.064)两两相比均有显著性差异(P<0.01);同组间男女无显著性差异(P>0.05);异常组先天性甲低、生长迟缓、佝偻病、早产4组疾病骨龄系数无显著性差异(P>0.05)。但生长迟缓组与其他两组间两两比较均有显著性差异(P<0.01)。结论:超声骨龄检查简单经济、无伤无痛,比目前常用的X线检查方法能更多的选取标志性骨化中心,不但结果更精确,而且可反复多次检查。骨龄系数的引入有利于骨龄的计算,超声多元计数法骨龄测定可客观评价婴儿骨龄,具有重要的临床价值。

Objective：To investigate feasibility of examination of infant bone age by ultrasonic sound and the value of multi-count method in infant bone age determination. Methods：5～8 HZ probe was used to scan 309 subjects,aged les than 1 year. There were 136 normal infants and 173 abnormal infants. We examined standard bone centres in six parts （i.e.,ankle,knee,hip,wrist,elbow and shoulder） on the left. According to appearance of mediam time of the bone centres,we counted bone age coefficient（the number of appeared bone centres/ the number of standard bone centres） and bone ages（infant age multiply bone age confficient. Results：There were significant difference in the bone centres age confficients between the girls in the two groups. There also existed significant difference in the bone centres age confficients between the boy in the two groups. There was no significant difference in the bone centres age confficients between boys and girls in the same group （P0.05）. There was no difference between the four subgroups of the abnormal group （congenital low potassium,stunting,rickets,preterm infants,P0.05）,but,there was significant difference between the stunting subgroup and the other three subgroups （P0.01）.Conclusion：Using sonography to examine infant bone age,which has the advantage of simple,economical and harmless,can not only select more standard bone centres and have more accurate result than the X-ray,but also,be repeated to check for many times. The introduction of bone age coefficient is conducive to calculation of bone age. Ultrasonic multi-count method can assess infant bone age objectively and provide a basis for clinical diagnosis and treatment.