【目的】 提出5岁以下婴幼儿骨龄评价方法。 【方法】 研究样本为《中国人手腕骨发育标准-中华05》研究中5岁以下组的2 468名(男1 245,女1 223)儿童,使用以概率单位法计算的TW3骨发育等级出现年龄为骨发育指数,采用LMS方法拟合手腕部桡尺、掌指骨(radius, ulna and short bones,RUS)、腕骨(carpal,CARP)(R+C)以及单独CARP的发育指数百分位数曲线。 【结果】 绘制出手腕部R+C和CARP法骨发育指数P₃、P₁₀、P₂₅、P₅₀、P₇₅、P₉₀、P₉₇评价图,拟合百分位数曲线下受试者例数的百分数与理论期望值相差在0.1%~2.3%之间。手腕骨发育速度存在明显的性别差异,男女R+C骨发育指数分别在1岁和0.5岁后、CARP发育指数分别在1.5岁和1岁后迅速增加,而且女童增加速度均明显大于男童。 【结论】 男女婴幼儿手腕部骨化中心在0.5岁后陆续出现,可参考使用R+C和CARP骨发育指数百分位数曲线图评价婴幼儿骨龄。

【Objective】 The methods for assessment of skeletal maturity in the children less than 5 years of age were provided. 【Methods】 The sample was 2 468(1 245 boys,1 223 girls)normal Han children aged 0~5 years from the study of "The Standards of Skeletal Maturity of Hand and Wrist for ChineseChina 05". The developmental index (DI) of bones in hand and wrist were estimated by the ages of attainment for TW3 skeletal development stages, which were calculated by probability unit. The LMS method was used to fit centile curves of DI for all bones of hand and wrist (R+C) and the Carpal bones (CARP). 【Results】 The smoothed 3rd, 10th, 25th, 50th, 75th, 90th, 97th centile curves were charted respectively for R+C and CARP, and the differences between percents of cases below the fitted centile curves and expected values were 0.1%~2.3%. There were notable sexual discrepancy in rate of skeletal development for hand and wrist. The DI of R+C were rapidly increased after 0.5 year in girls and 1 year in boys, and the DI of CARP after 1 year in girls and 1.5 years in boys, respectively. The increase of velocity for DI in girls was more rapid than in boys. 【Conclusions】 The ossification centre of boys and girls are appeared in succession after 0.5 year of age. The centile curves of DI for R+C and CARP should be used for skeletal maturity assessment in children less than 5 years of age.