不同年龄段正常儿童软骨厚度的超声测量分析

Ultrasound measurements of epiphyseal and joint cartilage thicknesses in healthy children at different ages

目的建立不同年龄阶段正常儿童骺软骨和关节软骨厚度参考值标准,为超声评估幼年特发性关节炎早期骺软骨和关节软骨病理改变奠定基础。方法测量503例不同年龄阶段正常儿童骺软骨和关节软骨厚度,其中男性336例,女性167例。共分为4个年龄组：①幼儿组（1～〈3岁）120例;②学龄前组（3～〈6岁）136例;③学龄组（6～〈10岁）124例;④青春期组（10～〈16岁）123例。分别用超声测量双侧肘、腕、第二掌指（metacarpophalangeal,MCP2）、第三掌指关节（MCP3）、髋、膝和踝关节的骺软骨和关节软骨厚度。结果所有软骨厚度在不同性别和年龄段间差异有统计学意义（P〈0.05）。男童各关节的软骨厚度均比同年龄段女童厚,年龄与软骨厚度呈线性相关,即软骨厚度均随年龄增长而减小。所有关节左右两侧软骨厚度差异无统计学意义（P〉0.05）。结论建立了不同年龄段正常儿童肘、腕、MCP2、MCP3、髋、膝和踝关节软骨厚度正常值参考范围。

Objective To establish standard reference values of normal epiphyseal cartilage and joint cartilage thicknesses of children at different ages, and found a basis of assessing the early changes in the cartilages of juvenile idiopathic arthritis （JIA） with uhrasound examination. Methods The thicknesses of the epiphyseal cartilage and joint cartilage were measured with ultrasonography in 503 healthy children, including 336 boys and 167 gifts in our department from May to August 2015. They were divided into 4 groups according to their ages, infant and toddler group （1- to 3-year-old, n = 120）, preschool group （3- to 6-year-old, n = 136）, school-age group （6- to 10-year-old, n = 124）, and adolescence group （10- to 16-year-old, n = 123）. The bilateral epiphyseal cartilage and joint cartilage thicknesses of the elbow, wrist, second metacarpophalangeal joint （MCP2）, third metacarpophalangeal joint （MCP3）, hip, knee and ankle joints were measured. ReSUltS The obtained cartilage thicknesses showed significant differences between different sexes and among different ages （P 〈 0.05 for all joints）. Boys had thicker cartilage than girls at the same ages. A linear correlation was observed between cartilage thickness and age, and cartilage thickness was decreased with the increase of age in both sexes. There was no obvious difference between the right and left side of all the investigated joints （P 〉 O. 05 ）. Conclusion We establish standard reference values for the normal thicknesses of epiphyseal and joint cartilages in the elbow, wrist, MCP2, MCP3, hip, knee and ankle joints at different aged-children.