【目的】 了解15岁以下儿童超声骨密度的现状和变化规律,为我国儿童保健、儿科临床、科研等工作提供正常人群的参考数据。 【方法】 采取整群抽样的方法,在珠海、昆明、郴州、苏州、安庆、扬州、成都和沈阳城市中,共调查从满1月到不满15岁的健康儿童29 276人,按男、女分成12个年龄组, 填写调查表格,常规测量儿童的体重、身高,统一采用“宏扬BMD-1000C型超声骨质分析仪”,在左小腿胫骨中段前方内侧面部位测量儿童的超声骨声速值。 【结果】 调查儿童中,男15 411名,女13 865名。1)超声骨密度值在1月到不满6月年龄组时最低,后随着年龄的增长骨密度逐渐增加,到12~15岁组时骨密度达到最大值;2)骨密度在性别之间无明显差异(t=0.824,P>0.05);3)骨密度值随着体重的增加逐渐增加。在16 kg以内随着体重的增加骨密度增加较快,16 kg以后,骨密度增加趋缓;4)随着身高的增加骨密度逐步增加。骨密度值的增长在75 cm之内增加稍慢,75到120 cm之间骨密度值快速增加,而后的增加则缓慢;5)各年龄组骨密度主成分预测模型:1)婴儿期的回归方程为:骨密度值=2 954.69×(月龄-4.91)×(体重+1.52)×身高;2)幼儿期的回归方程为:骨密度值=2 901.90×(年龄-20.86)×(体重+5.41)×身高;3)学龄前期的回归方程为:骨密度值=3 136.91×(年龄-7.69)×(体重+4.39)×身高;4)学龄期至青春期的回归方程为:骨密度值=3 480.06×(年龄-1.05)×(体重+0.61)×身高。 【结论】 本调查的0~15岁不同年龄组正常儿童的超声骨密度值,以及与年龄,体重和身高的相关关系可供临床参考。
Abstract
【Objective】 To examine the status and the growth pattern of the ultrasonic bone mineral density and to set up normal database of the children under 15 years in China for child health care, pediatrics clinical and scientific research. 【Methods】 With the cluster sampling in Zhuhai, Kunming, Chenzhou, Suzhou, Anqing, Yangzhou, Chengdu and Shenyang city, 29 276 healthy children, among them 15 411 boys and 13 865 girls, aged from 1 month to 15 years old, divided into 12 age groups, were investigated, filled in the questionnaire, measured the weight and height conventional, assayed the bone mineral density at the middle tibia ahead side in the left curs with the ultrasonic bone analyzer of "Hongyang 1000-C model" made in China. 【Results】 The data indicated that 1)the Ultrasonic BMD value was the lowest in the groups from 1 month to just 6 months, then gradually increased with the age increase, and reached the maximum from 12 to 15 years; 2)the bone mineral density was not significant difference between boys and girls(t=0.824,P>0.05); 3)the BMD value was increased gradually with weight increase and gained quickly when weight in the 16 kg, then gained slowly when weight out the 16 kg; 4)the BMD value was increased gradually with height increase and gained slowly when height in the 75 cm, but the increase quickly when the height from 75 cm to 120 cm, then the increase slightly slower; 5)the predictor formula of the BMD chief component in the every aged groups were as follow, 1)the BMD value=2 954.69×(months-4.91)×(weight+1.52)×height for infant age; 2)the BMD value=2 901.90×(age-20.86)×(weight+5.41)×height for toddle's age; 3)3 136.91×(age-21)×(weight+4.39)×height for preschool age; 4)3 480.06×(age-1.05)×(weight+0.61)×height for school age and adolescence. 【Conclusions】 The ultrasonic BMD value and the correlation coefficient with the age, weight and height of normal children under 15 years in different age groups in the data can be referenced clinically.
关键词
超声 /
骨 /
密度 /
儿童
Key words
ultrasound /
bone /
density /
children
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参考文献
[1] 九市儿童体格发育调查研究协作组.2005年中国九市7岁以下儿童体格发育调查研究[M].北京:人民卫生出版社,2008.
[2] 中国学生体质与健康研究组编.2000年中国学生体质与健康调研报告[M].北京:高等教育出版社,2002.
[3] Omar A, Turan S, Bereket A. Reference data for bone speed of sound measurement by quantitative ultrasound in healthy children [J]. Arch Osteoporos,2006,1(1):37-41.
[4] Nobuyuki M, Hiroko M, Chigusa M, et al. Bone status assessment in Japanese subuects using speed of sound along the tibia[J]. Chinese Medical Journal,2002,115(2):254-256.
[5] 刘石平,廖二元,吾贤平,等.胫骨定量超声和双能x线吸收法测量1596例女性骨密度的比较[J].医师进修杂志,2005,28(11):26-28.
[6] Knapp KM, Blake GM, Spector TD, et al. Can the WHO definition of osteoporosis be applied to multi-site axial transmission quantitative ultrasound?[J]. Osteoporos Int,2004,15(5):367-374.
[7] 黄恒君,项泾渭,刘晓梅.主成份回归分析的直接实现[J].甘肃科学学报,2007,19(2):107-109.
[8] Steelman J, Zeitler P. Osteoporosis in pediatrics [J]. Pediatr Rev,2001,22(2):56-65.
[9] Sievanen H, Cheng S, Ollikainen S, et al. Ultrasound velocity and cortical bone characteristics in vivo[J]. Osteoporos Int,2001,12(5):399-405.
[10] 吴光弛.中国儿童钙营养状况[J].营养健康新观察,2001,(3):11-14.
[11] Unal A, Gur E, Arvas A, et al. Bone density values in healthy Turkish infants[J]. Indian Pediatr,2000,37(5):497-503.
[12] 程淑敏,于大芳,郭文娟.3～10岁儿童年龄、身高及体重指数对全身及各部位骨密度的影响[J].现代预防医学,2007,34(24):4690-4691.
[13] 张李伟,刘加昌,翟凤英,等.北京市学龄儿童青少年骨密度正常参考值的研究[J].中国骨质疏松杂志,2003,9(2):134-136.
[14] Leonard CM, Roza MA, Barr RD, et al. Reproducibility of DXA measurements of bone mineral density and body composition in children[J]. Pediatr Radiol,2009,39(2):148-154.
[15] 程淑敏,王哲,陈艳.271例3~11岁儿童骨密度分析[J].中国妇幼保健,2006,21(19):2688-2689.
[16] 程淑敏,黄俊峰,王哲.97例5～7岁儿童身体成分分析[J].中国妇幼保健,2006,21(1):54-55.
[17] Geusens P, Cantatore F, Nijs J, et al. Heterogeneity of growth of bone in children at the spine, radius and total skeleton[J]. Growth Dev Aging,1991,55(4):249-56.
[18] Nelson DA, Simpson PM, Johnson CC, et al. The accumulation of whole body skeletal mass in third- and fourth-grade children: effects of age, gender, ethnicity, and body composition[J] Bone,1997,20(1):73-78.
[19] 伍西羽,伍贤平,张红,等.长沙地区青少年儿童男性与女性骨密度积累的比较[J].中国骨质疏松杂志,2008,14(12):865-874.
[20] 袁春华,徐劲松.儿童青少年的骨钙、骨密度及骨量与生长发育的关系[J].中国临床康复,2004,8(24):5092-5094.
[21] Wetzsteon RJ, Petit MA, Macdonald HM, et al. Bone structure and volumetric BMD in overweight children: a longitudinal study[J]. J Bone Miner Res,2008,23(12):1946-1953.
[22] 文江舸,刘艳,廖新,等.沈阳市5岁以上儿童骨密度分析研究[J].中国妇幼健康研究,2008,19(1):15-16.
[23] 邢晨芳,张烨峰,陈锦贤,等.深圳市儿童超声骨密度测定结果[J].现代预防医学,2005,32(4):292-294.
基金
宏扬科技社会发展基金(HYSDF200708)
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