Pediatric Endocrinology and Diabetology, University Children's Hospital, Tübingen, Germany.
Horm Res Paediatr. 2011;76(1):1-9. doi: 10.1159/000329372. Epub 2011 Jun 21.
This review examines the role of skeletal maturity ('bone age', BA) assessment in clinical practice. BA is mainly used in children with the following conditions: short stature (addressed in part 1 of this review), tall stature, early or late puberty, and congenital adrenal hyperplasia (all addressed in part 2). Various manual and automatic methods of BA assessment have been developed. Healthy tall children tend to have advanced BA and healthy short children tend to have delayed BA in comparison to chronological age. Growth hormone (GH) treatment of children with GH deficiency leads to a catch-up in BA that is usually appropriate for the height of the child. Response to GH is dependent on BA delay in young children with idiopathic short stature, and GH dosage appears to affect BA acceleration. In chronic renal failure, BA is delayed until puberty but then increases due to increased sensitivity of the growth plate to sex steroids, thus further impairing adult height. The assessment of BA provides an important contribution to the diagnostic workup and management of children with short stature.
这篇综述探讨了骨骼成熟度（“骨龄”，BA）评估在临床实践中的作用。BA 主要用于以下情况的儿童：身材矮小（本综述第 1 部分讨论）、身材高大、性早熟或晚熟以及先天性肾上腺增生症（本综述第 2 部分讨论）。已经开发出各种手动和自动 BA 评估方法。与实际年龄相比，健康高大的儿童的 BA 往往较为先进，而健康矮小的儿童的 BA 往往较为延迟。生长激素（GH）治疗生长激素缺乏症的儿童会导致 BA 的追赶，而这种追赶通常与儿童的身高相适应。对 GH 的反应取决于特发性身材矮小的幼儿 BA 延迟的程度，并且 GH 剂量似乎会影响 BA 的加速。在慢性肾衰竭中，BA 延迟到青春期，但随后由于生长板对性激素的敏感性增加而增加，从而进一步损害成年身高。BA 的评估对身材矮小儿童的诊断和治疗有重要贡献。
