Wang Anru, Yang Fangling, Yu Baosheng, Shan Ye, Gao Lanying, Zhang Xiaoxiao, Peng Ya
Department of Pediatric Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210003, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2013 Jul;42(4):411-7.
To investigate the maturation of individual bones on the hand and wrist in children with central precocious puberty (CPP) and idiopathic short stature (ISS).
Hand and wrist films of 25 children with CPP, 29 children with ISS and 21 normal controls were evaluated by conventional Greulich-Pyle (GP) atlas method and individual bone assessment method, in which all twenty bones of the hand and wrist were evaluated based on GP atlas, including 2 radius and ulna, 7 carpal bones, 11 metacarpal and phalangeal bones, the average bone age (BA) was calculated. The differences in groups were analyzed by independent samples t test. The differences between the two methods were analyzed by paired sample t test. The differences between BA and chronological age (CA) were analyzed by ROC with SPSS 17.0.
Compared with the normal control group, the advance of BA in the CPP group was 0.70-2.26 y (1.48 ±0.78) by the GP atlas method, while that was 0.28-2.00 y(1.14 ±0.86) by the individual bone evaluation method. In all twenty bones, the advance of metacarpal and phalangeal BA was the greatest [0.34-2.06 y(1.2±0.86)]. In the ISS group,the delay of BA was 0.47-2.91 y(-1.69±1.22) by the GP atlas method, while that was 0.48-2.50 y (-1.49±1.01) by individual bone evaluation method.The delay of carpal BA was the greatest [0.59-2.73 y(-1.66±1.07)] in all twenty bones. In the ISS group and the normal control group, there were no statistic differences between the two methods. In the CPP group, statistic difference was found between two methods. There were no statistic differences for the areas under ROC curves between two methods.
The advance of metacarpal and phalangeal BA is the greatest in CPP group and the delay of carpal BA is the greatest in ISS group.Both methods provide diagnostic information for bone age in CPP and ISS children.
研究中枢性性早熟（CPP）和特发性矮小症（ISS）患儿手部和腕部各骨的成熟情况。
采用传统的格雷利希-派尔（GP）图谱法和单骨评估法对25例CPP患儿、29例ISS患儿及21例正常对照儿童的手部和腕部X线片进行评估。单骨评估法是基于GP图谱对腕部和手部的20块骨进行评估，包括2块桡骨和尺骨、7块腕骨、11块掌骨和指骨，并计算平均骨龄（BA）。采用独立样本t检验分析组间差异，采用配对样本t检验分析两种方法之间的差异，使用SPSS 17.0软件通过ROC分析BA与实际年龄（CA）之间的差异。
与正常对照组相比，CPP组采用GP图谱法时BA提前0.70 - 2.26岁（1.48±0.78），采用单骨评估法时BA提前0.28 - 2.00岁（1.14±0.86）。在全部20块骨中，掌骨和指骨的BA提前最为明显[0.34 - 2.06岁（1.2±0.86）]。ISS组采用GP图谱法时BA落后0.47 - 2.91岁（-1.69±1.22），采用单骨评估法时BA落后0.48 - 2.50岁（-1.49±1.01）。在全部20块骨中，腕骨的BA落后最为明显[0.59 - 2.73岁（-1.66±1.07）]。在ISS组和正常对照组中，两种方法之间无统计学差异。在CPP组中，两种方法之间存在统计学差异。两种方法的ROC曲线下面积无统计学差异。
CPP组掌骨和指骨的BA提前最为明显，ISS组腕骨的BA落后最为明显。两种方法均能为CPP和ISS患儿的骨龄提供诊断信息。
