生长激素在软骨发育不全和软骨骨化中的作用：手部 X 射线评估。

Role of growth hormone in enchondroplasia and chondral osteogenesis: evaluation by X-ray of the hand.

机构信息

Departments of Pediatrics, Western Galilee Hospital Naharia and the Faculty of Medicine, Bar-Ilan University, Safed, Israel.

Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden.

出版信息

Pediatr Res. 2014 Jul;76(1):109-14. doi: 10.1038/pr.2014.56. Epub 2014 Apr 14.

DOI:10.1038/pr.2014.56

PMID:24732105

Abstract

BACKGROUND

The process of growth and maturation of long (radius and ulna) and short (metacarpals and phalanges) bones of the hand (enchondroplasia) differs from that of the carpal cuboid bones (chondral osteogenesis). This study aimed to assess the impact of growth hormone (GH) on these two processes of bone maturation.

METHODS

Subjects of the study were 95 prepubertal children: 30 children with GH deficiency and 65 children with idiopathic short stature, aged 7.4 ± 1.9 y (mean ± SD) (trial registration number 98-0198-033). Bone maturation was assessed by the Greulich and Pyle method from X-rays obtained at the start and at 1 and 2 y of GH treatment, separately for carpals, long bones, and short bones, and was expressed as years of delay relative to chronological age.

RESULTS

At GH start, the delay in bone maturation in the GH-deficient group was significantly greater for carpals (3.6 ± 1.3 y) than for long (3.0 ± 1.3 y) and short (1.7 ± 1.1 y) bones. The delay was nonsignificantly greater for carpal bones in GH-deficient subjects than in subjects with idiopathic short stature (3.6 ± 1.3 vs. 3.1 ± 1.1 y, respectively) and was normalized after 2 y of GH treatment.

CONCLUSION

The dominant effect of GH was on chondral osteogenesis, with milder effect on enchondroplasia. A distinct delay in carpal and long-bone maturation, which normalizes during 2 y of GH treatment, was typical in GH-deficient children. Therefore, separate carpal bone assessment in bone age reading is needed.

摘要

背景

手的长骨（桡骨和尺骨）和短骨（掌骨和指骨）的生长和成熟过程（骺板生长）与手的腕骨（软骨内成骨）不同。本研究旨在评估生长激素（GH）对这两个骨成熟过程的影响。

方法

研究对象为 95 名青春期前儿童：30 名生长激素缺乏症儿童和 65 名特发性身材矮小儿童，年龄 7.4±1.9 岁（平均值±标准差）（试验注册号 98-0198-033）。骨成熟度分别通过 GH 治疗开始时、1 年和 2 年的 X 射线，根据 Greulich 和 Pyle 方法，从腕骨、长骨和短骨进行评估，并以相对于实际年龄的骨龄延迟年来表示。