青少年手腕骨骨龄与生活年龄的差异观察

目的比较以不同骨龄标准所评价的青少年手腕骨骨龄与生活年龄的差异，观察生长发育长期变化对青少年年龄推测的影响。方法从中国5座大中城市抽取11464名（男5873，女5591）3～18岁汉族正常青少年儿童，并另随机抽取950名（男516，女434）12～18岁骨发育正常的汉族青少年作为验证样本。按CHN法和RC法骨龄标准评价手腕部X线片骨龄，并对不同方法评价的骨龄及生活年龄进行统计学分析。结果各年龄组CHN法骨龄中位数大于RC骨龄，其差异具有显著性意义（P〈0．05）。验证样本中，在男12—16．5岁、女12～14．5岁之间，CHN骨龄减生活年龄之差值分别为0．35—1．00岁和0．57～1．16岁（P〈0．01）；RC骨龄减生活年龄的差值分别为-0．26—0．23岁和-0．27～0．06岁（P〉0．05）。在男17～18岁、女15～17岁之间，CHN骨龄减生活年龄的差值分别为-0．52～-1．05岁和-0．16～-1．13岁（P〈0．05），RC骨龄减生活年龄的差值分别为-0．35～-0．48岁和-0．22～-0．79岁（P〈0．05）。结论CHN法骨龄高于生活年龄，在大部分年龄组RC骨龄与生活年龄基本一致。

The observation of difference between skeletal age and chronological age with hand and wrist in Chinese Han adolescent

Objective The age estimated by skeletal age of hand and wrist were compared between different standards in adolescent,in order to observe the effects of secular trend of skeletal development to age estimation.Methods The sample consisted of was 11464(5873 boys,5591 girls)normal urban Han children aged 3～18 years from cities of China in 2005 years.To verify the results in first sample,the control sample was consisted of 950 normal urban Han children aged 12～18 years.The radiographs of hand and wrist of all subjects were estimated by CHN and RC methods.The relations between skeletal age estimated by CHN or RC norm and chronological age were investigated.Results In the sample medians for CHN skeletal ages were advanced relative to RC skeletal age in every age group,there were significantly differences between them(P<0.05).In control sample,from 12～16.5 years for boys and 12～14.5 years for girls,the differences of skeletal age minus chronological age were 0.35～1.00 years and 0.57～1.16 years(P<0.01) for CHN method,-0.26～0.23 years and-0.27～0.06 years(P>0.05) for RC method respectively;and from 17～18 years for boys and 15～17 years for girls,the differences of skeletal age minus chronological age were-0.52～-1.05 years and-0.16～-1.13 years(P<0.05) for CHN method,-0.35～0.48 years and-0.22～0.79 years(P<0.05) for RC method,respectively.Conclusions The chronological ages were overestimated by CHN skeletal age and the RC skeletal ages were generally coincided with chronological ages of a majority of age groups in the contemporary adolescent.