骨龄评价在儿童保健中的作用

摘要/Abstract

摘要： 骨龄可用来评价儿童的骨发育程度,也是衡量儿童生物年龄的客观指标。骨龄在儿童保健领域应用极其广泛,进行儿童生长发育监测时,可根据骨龄来评价和分析儿童体格生长是否与生物年龄一致,早期发现生长偏离,尤其是线性生长异常。骨龄还可以预示儿童青春期发育情况,可对剩余身高生长潜能进行早期评估,是国际通用的预测成年身高的唯一客观指标。骨龄评价是儿童疾病诊断和监测的重要辅助手段,普遍应用的特发性矮身高儿童的诊断依据中,骨龄延迟是其中重要的表现和诊断依据之一。生长激素缺乏儿童通常表现为骨龄异常延迟,骨龄变化是生长激素治疗效果的重要监测指标。甲状腺功能异常通常也表现为骨龄的异常提前或落后。骨龄异常提前于生活年龄,也是性早熟的重要诊断指标。在儿童保健领域使用骨龄时,应考虑靶身高、种族特点、营养状况的长期趋势、不同评价方法间的差异等因素,合理和客观地使用这一指标。

关键词: 骨龄, 生长发育, 身高预测, 生长异常

中图分类号:

R179

王燕,张绍岩,蒋竞雄. 骨龄评价在儿童保健中的作用[J]. 中国儿童保健杂志, 2013, 21(3): 285-287.

参考文献

[1] 许寿生,熊开宇.骨龄研究现状与进展[J].北京体育大学学报,2007,30 (7):944-948.
[2] 杨运.骨龄测定对儿童生长发育的指导作用[J].现代中西医结合杂志,2009,18(17):2049-2050.
[3] Dewey KG,Begum K.Long-term consequences of stunting in early life[J].Matern Child Nutr,2011,7(3S):5-18.
[4] Paternoster L,Howe LD,Tilling K,et al.Adult height variants affect birth length and growth rate in children[J].Hum Mol Genet,2011,20(20):4069-4075.
[5] Lee JM,Appugliese D,Coleman SM,et al.Short stature in a population-based cohort:social,emotional,and behavioral functioning[J].Pediatrics,2009,124(3):903-910.
[6] 朱琳.骨龄与生长发育的关系研究[J].哈尔滨体育学院学报,2011,29(5):1-5.
[7] Tuchman S,Thayu M,Shults J,et al.Interpretation of biomarkers of bone metabolism in children:impact of growth velocity and body size in healthy children and chronic disease[J].J Pediatr,2008,153(4):484-490.
[8] Nascimento VG,Bertoli CJ,Leone C.Ratio of weight to height gain:a useful tool for identifying children at risk of becoming overweight or obese at preschool age[J].Clinics,2011,66(7):1223-1226.
[9] 马莹,于泓.肥胖儿童骨龄提前的病例分析[J].中国现代药物应用,2009,3(17):186-190.
[10] 许文萍,赵桂臣,刘晓红,等.CHN骨龄评估在儿科内分泌疾病的应用[J].新疆医学,2008,38(1):75-76.
[11] Akridge M,Hilgers KK,Silveira AM,et al.Childhood obesity and skeletal maturation assessed with Fishman's hand-wrist analysis[J].Am J Orthod Dentofacial Orthop,2007,132 (2):185-190.
[12] De Onis M,Garza C,Onyango AW,et al.WHO Child Growth Standards[J].Acta Paediatrica,2006,450(S):56-65.
[13] De Onis M,Siyam A,Borghi E,et al.Comparison of the World Health Organization growth velocity standards with existing US reference data[J].Pediatrics,2011,128(1):e18-26.
[14] Bong Y,Shariff A,Majid A,et al.Reference charts for height and weight of school children from west malaysia in comparison with the United States centers for disease control and prevention[J].Iran J Public Health,2012,41(2):27-38.
[15] 中华人民共和国卫生部妇幼保健与社区卫生司.中国儿童生长标准与生长曲线[M].上海:第二军医大学出版社,2009.
[16] 唐进,罗家有,叶卫华,等.0~5岁儿童股骨头骨骺生长发育研究[J].临床小儿外科杂志,2009,8(5):28-32.
[17] 曾鲼生,王德芬.现代儿科内分泌学-基础与临床[M].上海:上海科学技术文献出版社,2001:543-545.
[18] Topor LS,Feldman HA,Bauchner H,et al.Variation in methods of predicting adult height for children with idiopathic short stature[J].Pediatrics,2010,126(5):938-944.
[19] David A,Hwa V,Metherell LA,et al.Evidence for a continuum of genetic,phenotypic,and biochemical abnormalities in children with growth hormone insensitivity[J].Endocr Rev,2011,32(4):472-497.
[20] Kristrm B,Aronson AS,Dahlgren J,et al.Growth hormone (GH) dosing during catch-up growth guided by individual responsiveness decreases growth response variability in prepubertal children with GH deficiency or idiopathic short stature[J].J Clin Endocrinol Metab,2009,94(2):483-490.
[21] Beltro CB,Juliano AG,Chammas MC,et al.Etiology of congenital hypothyroidism using thyroglobulin and ultrasound combination[J].Endocr J,2010,57(7):587-593.
[22] 宁刚,曲海波,刘关键,等.TW2、TW3法腕骨骨龄评价方法的诊断性试验[J].法医学杂志,2007,23(2):97-100.