儿童骨龄评估和临床研究进展

Clinical significance of skeletal age assessment in children

骨骼的生长发育受到营养、内分泌、遗传等多种因素的影响.骨骼生长发育呈现一定的规律性,这种规律性用时间表示即为骨龄.骨龄评估方法的选择、评估技术手段不同、疾病等均可影响其准确性.目前临床上用来评估儿童骨龄的主要方法为GP法和TW法.GP法适用于快速筛查,TW法耗时但准确性最高.我国临床常用的还包括CHN法.随着技术发展,计算机自动骨龄评估以及超声骨龄评估亦逐步应用于临床.骨龄评估在儿童遗传内分泌疾病如矮小、性早熟的诊治过程中发挥重要作用,有助于准确评价儿童生长发育以及预测身高.为进一步提高儿童骨龄评估准确性,该文就儿童骨龄评估相关方法、技术的新进展以及相关临床应用进行综述.

Bone development is influenced by a number of factors,including nutrition,hormonal secretions,and genetics.Skeletal age assessment(SAA) is a clinical procedure,which is used in determining the skeletal age(SA) of children and adolescents.The selection of evaluation methods,the difference of evaluation techniques,and the influence of disease can affect the accuracy of SAA.Currently,the main clinical methods for SAA are the Greulich-Pyle(GP) and Tanner-Whitehouse(TW)methods.The GP method has the advantage of being quick and easy to use.The method of TW,however,seems to be more reliable than the GP method.In China,the CHN method is also used.With the development of technology,the computer automatic SAA and ultrasonic SAA are gradually applied in clinical practice.The SAA plays an important role in the diagnosis and treatment of endocrine diseases,such as short stature and precocious puberty,and also in the children's growth and development.In order to improve the accuracy of SAA,this article reviews the related methods,techniques and clinical applications.