Faculty of Public Health, College of Medicine, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
Clin Rheumatol. 2013 Sep;32(9):1309-16. doi: 10.1007/s10067-013-2267-6. Epub 2013 Apr 28.
We investigated the clinical features of bone and joint lesions in children with Kashin-Beck disease (KBD) and the association of these features with their parents to determine specific clinical features for diagnosing KBD. A total of 2,248 children (4 to 18 years old) and their parents were examined by stratified cluster sampling from 33 villages in six endemic counties and from six villages in a non-endemic county. We collected individual information, clinical symptoms, and radiological signs of the right hand. KBD in children and their parents was assessed using the "Diagnosis Criteria of Kashin-Beck disease in China (WS/T207-2010)." Univariate and multivariate analyses were used to examine the correlation of clinical features between parents and offspring with KBD. The rates of clinical features in children were correlated with those in parents (P < 0.01). The parents of child cases had higher rates of clinical features than the parents of child controls. The prevalence of radiographic alterations in the distal end of the phalanges in the parents of child cases was significantly higher than that in the parents of child controls (father, χ (2) = 14.83, P = 0.001; mother, χ (2) = 10.41, P = 0.001). The parents of child cases were more likely to be KBD cases than the parents of controls (adjusted odds ratio, 4.4-12.1). Recognizing significant correlations in clinical features between children and their parents with KBD is helpful for early clinical diagnosis and evaluation of disease severity. Some clinical features of KBD, such as radiographic alterations in the distal end of the phalanges, might be useful for diagnosing KBD.
我们调查了儿童大骨节病（KBD）骨骼关节病变的临床特征及其与父母的关联，以确定用于诊断 KBD 的特定临床特征。采用分层整群抽样方法，从 6 个流行县的 33 个村和 1 个非流行县的 6 个村，对 2248 名 4-18 岁儿童及其父母进行了调查。我们收集了个人信息、临床症状和右手的影像学表现。采用《中国大骨节病诊断标准（WS/T207-2010）》对儿童及其父母的 KBD 进行评估。采用单因素和多因素分析方法，分析 KBD 患儿及其父母的临床特征相关性。儿童的临床特征率与父母的临床特征率相关（P<0.01）。病例组儿童的父母具有更高的临床特征率。病例组儿童的父母掌指骨远端影像学改变的发生率明显高于对照组儿童的父母（父亲，χ²=14.83，P=0.001；母亲，χ²=10.41，P=0.001）。病例组儿童的父母比对照组儿童的父母更有可能是 KBD 患者（调整优势比，4.4-12.1）。认识到具有 KBD 的儿童与其父母之间临床特征的显著相关性有助于早期临床诊断和疾病严重程度的评估。掌指骨远端影像学改变等一些 KBD 的临床特征可能有助于 KBD 的诊断。
