中国组织工程研究

中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (5): 662-667.doi: 10.3969/j.issn.2095-4344.2995

• 骨组织构建 bone tissue construction • 上一篇    下一篇

Greulich-Pyle图谱法、CHN法和中华05法评估儿童青少年骨龄的比较

潘其乐1，张  洪2，周慧康3，蔡  广1   

  1. 1上海体育科学研究所(上海市反兴奋剂中心)，上海市   200030；2 上海市金山区青少年业余体育学校，上海市   201508；3 上海市徐汇区第二青少年业余体育学校，上海市   200030
  • 收稿日期:2019-12-23 修回日期:2019-12-28 接受日期:2020-02-26 出版日期:2021-02-18 发布日期:2020-11-27
  • 通讯作者: 蔡广，副研究员，硕士生导师，上海体育科学研究所(上海市反兴奋剂中心)，上海市 200030
  • 作者简介:潘其乐，女，1990年生，浙江省温州市人，汉族，英国埃克塞特大学运动与健康科学专业毕业，硕士，主要从事运动员选材育才研究。
  • 基金资助:
    上海市科学技术委员会科研计划项目(18DZ1200600)

Comparison of the Greulich-Pyle method, the CHN method and the China 05 method for assessing bone age in children and adolescents

Pan Qile1, Zhang Hong2, Zhou Huikang3, Cai Guang1   

  1. 1Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Center), Shanghai 200030, China; 2 Shanghai Jinshan Amateur Athletic School, Shanghai 201508, China; 3Second Youth Amateur Sports School of Xuhui District, Shanghai 200030, China
  • Received:2019-12-23 Revised:2019-12-28 Accepted:2020-02-26 Online:2021-02-18 Published:2020-11-27
  • Contact: Cai Guang, Associate researcher, Master’s supervisor, Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Center), Shanghai 200030, China
  • About author:Pan Qile, Master, Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Center), Shanghai 200030, China
  • Supported by:
    Scientific Research Project of Shanghai Municipal Science and Technology Commission, No. 18DZ1200600

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摘要：

文题释义：
骨龄：是骨骼年龄的简称，需要借助于骨骼在X射线摄像中的特定图像来确定。通常要拍摄人左手手腕部的X射线片，医生通过X射线片观察左手掌指骨、腕骨及桡尺骨下端的骨化中心的发育程度，来确定骨龄。
骨龄结果与生活年龄差值：发育成正态分布的群体，大多数发育应该是同步的，发育偏晚或者偏早，只是少数，因此发育呈正态分布的群体的骨龄与生活年龄应该是同步的，也就是说该群体骨龄与生活年龄是一致的。因此骨龄评估方法效果需要比较群体骨龄结果与生活年龄差值大小，差值越趋近于0，说明该骨龄评估方法越符合当地儿童的生长发育实际情况。

背景：目前在国内医学和体育领域有3种骨龄评估方法较为广泛应用，分别为Greulich-Pyle图谱法(GP法)、CHN计分法(CHN法)、中华05法，哪种方法更适合本地区的儿童青少年评估，需要进行大样本研究实证。
目的：以上海市健康儿童为样本，比较GP法、CHN法、中华05法骨龄，为经济发达东部地区儿童青少年选用合适的骨龄评估方法提供参考。
方法：受试者为上海市市区4 152名(男2 185，女1 967)儿童青少年，分别以GP法、CHN法、中华05法骨龄标准评价所有受试者左手腕部X射线片骨龄，以骨龄与生活年龄之间的差值评价不同骨龄标准的适用性。项目经上海体育科学研究所伦理委员会通过，受试学生放家长均知情同意。
结果与结论：①GP法，6-8岁男女骨龄与生活年龄差值为-0.12至-0.65岁，其中女子8岁差异无显著性，其他组均有差异具有显著性，≥9岁差值为0.18-1.62岁，除9岁年龄段外，其他组差异均具有显著性；②CHN法，男6-17岁和女6-16岁，骨龄与生活年龄差值为0.42-1.56岁(P < 0.01)；③中华05法，男子6-16岁，骨龄与生活年龄差值在0.20-0.53(P < 0.01)，17岁差值为0.08(P > 0.05)，18岁组为-0.60(P < 0.01)；女6-17岁，骨龄与生活年龄差值在-0.01-0.56，大部分年龄组差异无显著性意义；④在3种评估方法中，中华05法评估结果相对来说较好，最为符合当前上海市青少年发育状态，提示中华05法更适合于经济水平类似于上海东部发达地区。3种评估方法都有一定的局限性，由于青少年生长长期趋势影响，也有必要再次修订目前使用的各种骨龄评估标准。
https://orcid.org/0000-0001-6842-4027 (潘其乐) 

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 骨龄, 发育评估, GP法, CHN法, 中华05法, 青少年, 发育, X射线

Abstract: BACKGROUND: In China, three bone age assessment methods have been widely used in the medical and sports fields, including the  Greulich-Pyle atlas method (GP method), CHN scoring method (CHN method), and China 05 method. A large-sample empirical study is required to determine which method is more suitable for assessing bone age of children and adolescents.
OBJECTIVE: To provide a scientific evidence for appropriate bone age evaluation standards for children and adolescents in the eastern developed areas, by comparing the GGP method, CHN method and China 05 method based on samples of healthy children from Shanghai. 
METHODS: A total of 4 152 healthy children and adolescents (2 185 boys and 1 967 girls) from the urban area of Shanghai were selected for the study. Their digital X-ray of the left hand and wrist were collected and evaluated by the GGP method, CHN method and China 05 method. The difference between the bone age and the chronological age was used to assess the applicability of different bone age standards. The study was approved by the Ethics Committee of Shanghai Research Institute of Sports Science, and informed consent was given by all parents of the enrolled students.
RESULTS AND CONCLUSION: For the GP method, the difference between bone age and chronological age in both genders at the age of ≥ 8 years was -0.12 to -0.65 year with significant difference, except for 8-year-old girls. The significant age difference at the age of ≥ 9 years was 0.18 to 1.62 year, except for the 9-year-old age group. For the CHN method, the difference between bone age and chronological age among 6-17-year-old boys and 6-16-year-old girls was 0.42 to 1.56 years (P < 0.01). For the China 05 method, the difference between bone age and chronological age was 0.20 to 0.53 in 6-16-year-old boys (P < 0.01), 0.08 in 17-year-old boys (P > 0.05), and -0.60 in 18-year-old boys (P < 0.01); the age difference among 6-17-year-old girls was -0.01 to 0.56 year, and the difference was not significant in most age groups. Among the three methods, the result of China 05 method is relatively better, which is the best method that matches the current development of teenagers in Shanghai, suggesting that the China 05 method is more suitable for the eastern developed areas with economic level similar to Shanghai. All the three methods have some limitations. Considering the long-term growth trend of adolescents, it is necessary to revise the current bone age evaluation standards.

Key words: bone age, developmental evaluation, the GP method, the CHN method, the China 05 method, adolescent, growth, X-ray

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