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中枢性性早熟女童颈椎和手腕的头影测量特征及骨骼成熟度评估

Evaluation of cephalometric characteristics and skeletal maturation of the cervical vertebrae and hand-wrist in girls with central precocious puberty.

作者信息

Kang Sung-Tae, Choi Sung-Hwan, Kim Kyung-Ho, Hwang Chung-Ju

机构信息

Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.

BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea.

出版信息

Korean J Orthod. 2020 May 25;50(3):181-187. doi: 10.4041/kjod.2020.50.3.181.

Abstract

OBJECTIVE

This study aimed to evaluate the differences in cephalometric characteristics and skeletal maturation in girls with central precocious puberty (CPP) via lateral and hand-wrist radiographs. We also aimed to identify the indicators that are most effective for determining skeletal maturity in these patients.

METHODS

The study included 70 Korean girls (mean age, 8.5 ± 0.5 years) diagnosed with CPP at the Department of Pediatrics, and 48 normal healthy age-matched girls who visited the Department of Orthodontics and had no history of hormone treatment or growth problems. Skeletal maturation was evaluated using lateral cephalometric and hand-wrist radiographs using cervical vertebrae maturation indicators (CVMI) and skeletal maturity indicators (SMI).

RESULTS

The mean mandibular plane angle was smaller in the CPP group than in the control group (35.8° ± 4.9° vs. 39.0° ± 6.5°), resulting in greater posterior facial height ( = 0.003). SMI was significantly greater in the CPP group (3.5 ± 1.4 vs. 2.0 ± 1.0) than in the control group ( = 0.001) and was significantly associated with CPP ( = 0.492; = 0.001), whereas CVMI was not.

CONCLUSIONS

In comparison with the control group, the CPP group exhibited a smaller mandibular plane angle, greater posterior facial height, and greater skeletal maturation. SMI may be more suitable than CVMI for determining skeletal maturation in CPP. Hand-wrist radiography is recommended in addition to lateral cephalogram for predicting growth in girls with CPP.

摘要

目的

本研究旨在通过头颅侧位片和手腕部X线片评估中枢性性早熟(CPP)女童的头影测量特征和骨骼成熟度差异。我们还旨在确定对这些患者骨骼成熟度判断最有效的指标。

方法

本研究纳入了70名在儿科诊断为CPP的韩国女童(平均年龄8.5±0.5岁),以及48名年龄匹配、健康、无激素治疗史或生长问题且前往正畸科就诊的正常女童。使用颈椎成熟度指标(CVMI)和骨骼成熟度指标(SMI),通过头颅侧位片和手腕部X线片评估骨骼成熟度。

结果

CPP组的平均下颌平面角小于对照组(35.8°±4.9° vs. 39.0°±6.5°),导致面部后份高度更大(P = 0.003)。CPP组的SMI显著高于对照组(3.5±1.4 vs. 2.0±1.0)(P = 0.001),且与CPP显著相关(r = 0.492;P = 0.001),而CVMI则不然。

结论

与对照组相比,CPP组表现出更小的下颌平面角、更大的面部后份高度和更大的骨骼成熟度。在CPP患者中,SMI可能比CVMI更适合用于确定骨骼成熟度。除头颅侧位片外,建议加做手腕部X线片以预测CPP女童的生长情况。

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