三种常用骨龄评价方法的比较

Comparison of three methods for the assessment of bone age in children with growth hormone deficiency

为探讨国内常用的骨龄评价方法G-P图谱、中国人骨成熟评价标准-CHN记分法(CHN法)及儿童青少年骨龄评分法(叶氏评分法)的特点及应用选择,用上述三种骨龄评价方法,对一组生长激素缺乏症(GHD)的骨龄片进行了评价。结果提示:①G-P图谱评价的骨龄明显小于CHN法和叶氏评分法,P<0.05。而CHN法与叶氏骨龄评分法评价的骨龄值接近。②用叶氏评分法评价GHD患者治疗前后的骨龄变化显示该评分法中的R、C评分系统评价的骨龄值不平行。结论:G-P图谱简便,可用于大致估计骨龄范围;叶氏评分法精确,宜用于精确骨龄监测及科研;CHN法准确,相对省时,适用临床常规骨龄评价。

To compare the features and clinical application of three methods for the assessment of bone age, 54 roent-genograms of hand and wrist from children with idiopathic growth hormone deficiency (GHD) were assessed by Greulich and Pyle atlas (G-P Atlas), Zhang Shaoyan' s CHN method (CHN' s method) and Ye Yiyan' s method(Ye's method) for Chinese children and adolescents, respectively. The results showed that the bone age assessed by G-P Atlas was significantly younger than that assessed by other two ways (P<0. 05). There was a similar value used by either CHN' s method or Ye' s methods. A unparalleled values of the bone age in GHD children were noticed before and after r-hGH administration assessed by either C or R systems of Ye' s method. It is suggested that G-P Atlas can be used to estimate a approximate range of bone age as a simple way, Ye's method can be used to monitor the bone age exactly and to do research as a precision way, and CHN' s method will be more suitable to be used clinical practice routinely as a accurate and relatively timesaving way.