Bettendorf M, Graf K, Nelle M, Heinrich U E, Tröger J
Division of Paediatric Endocrinology, Children's Hospital, University of Heidelberg, Germany.
Arch Dis Child. 1998 Aug;79(2):165-8. doi: 10.1136/adc.79.2.165.
To assess the usefulness of the metacarpal index (MCI) as a radiographic measure of the proportions of the metacarpals in the differential diagnosis of short stature. To investigate the significance of the MCI in following the longitudinal growth and proportions of individual long bones during growth hormone stimulated catch up growth in children with short stature with and without growth hormone deficiency.
124 children, including 65 children with short stature caused by growth hormone deficiency, 13 with familial short stature, 29 with idiopathic short stature, and 17 with Ullrich-Turner syndrome.
Retrospective analysis of the MCI in five posterior-anterior radiographs of the left hand of all patients, which were performed sequentially for routine bone age determinations (Greulich and Pyle) before and during the first three years of growth hormone treatment.
The MCI was similar in all patient groups, resembled that of healthy children, and correlated significantly with chronological age, bone age, and height before and during growth hormone treatment. Despite a remarkable growth hormone stimulated catch up growth, the MCI did not change significantly during growth hormone treatment.
The role of the MCI is insignificant in the diagnosis of short stature, but the MCI can serve as an auxological measure of osseous proportions during longitudinal growth. Growth hormone treatment accelerates longitudinal growth without affecting the proportions of the long bones, indicating that growth hormone stimulated bone growth closely resembles spontaneous bone growth.
评估掌骨指数（MCI）作为掌骨比例的影像学测量指标在矮小症鉴别诊断中的作用。研究MCI在生长激素刺激下，身材矮小且伴有或不伴有生长激素缺乏的儿童追赶生长过程中，对个体长骨纵向生长及比例变化的意义。
124名儿童，包括65名因生长激素缺乏导致身材矮小的儿童、13名家族性矮小儿童、29名特发性矮小儿童以及17名乌尔里希-特纳综合征患儿。
对所有患者左手的五张后前位X光片进行MCI的回顾性分析，这些X光片是在生长激素治疗的前三年及治疗期间，为常规测定骨龄（格-派氏法）而依次拍摄的。
所有患者组的MCI相似，与健康儿童的MCI相近，并且与实际年龄、骨龄以及生长激素治疗前后的身高均显著相关。尽管生长激素刺激导致显著的追赶生长，但在生长激素治疗期间MCI并未发生明显变化。
MCI在矮小症诊断中的作用不显著，但MCI可作为纵向生长过程中骨骼比例的体格测量指标。生长激素治疗可加速纵向生长，而不影响长骨比例，这表明生长激素刺激的骨骼生长与自然骨骼生长非常相似。
