摘要
目的探讨正常儿童中GP图谱法(GP法)和中华05法评估骨龄的一致性,并与生活年龄比较。方法纳入上海市徐汇区和静安区5所小学和中学的6~18岁健康在校中小学生,拍摄左手X线骨龄片,由2名骨龄阅片专家分别独立进行GP法和中华05法评估。采用Pearson相关方法分析GP法骨龄、中华05法骨龄、生活年龄的相关性,采用Kappa方法对GP法骨龄、中华05法骨龄与生活年龄的差值范围行一致性检验。结果 2015年12月至2016年10月4 151名学生完成骨龄片采样,男2 184名,女1 967名。①Pearson分析:在总体和不同发育阶段的男、女生中,GP法骨龄和中华05法骨龄相关系数r为0.888~0.988(P<0.000 1);GP法骨龄或中华05法骨龄与生活年龄的相关系数r为0.487~0.851(P均<0.001)。②Kappa分析:在总体和不同年龄段的男、女生中,Kappa值均<0.5。③在男生10岁、女生9岁前GP法骨龄小于中华05法骨龄(P<0.000 1),女生9岁时2种方法评估的骨龄一致(P>0.05),之后男、女生GP法骨龄均大于中华05骨龄(P<0.000 1)。④与GP法相比,中华05法骨龄更接近于男、女生的生活年龄。结论在正常儿童青少年中,GP法和中华05法评估骨龄的一致性较低,需结合其他发育指标进行发育状态评估。就本次采样人群而言,中华05法骨龄更接近于生活年龄。
Objective To investigate the consistency between the Greulich-Pyle method and the China 05 method for assessing bone age in normal children,and to compare the assessment results with the chronological age.Methods All subjects,collected from 5 primary and secondary schools in Xuhui and Jing'an districts of Shanghai,were taken with orthotopic left-handed DR digital radiography,and two experts performed the GP method and the China 05 method,respectively.Pearson's analysis was used to analyze the correlation of the two methods and Kappa analysis was used to test the consistency of differences between the assessment results and the chronological age.Results A total of 4,151 students,including 2,184 males and 1,967 females,completed the bone age sampling from December 2015 to October 2016.Pearson's analysis showed two assessment results were highly correlated in general and by developmental stages(r=0.888-0.988,P<0.0001).The correlation coefficient r between the two methods and the chronological age ranged from 0.487 to 0.851(P<0.001 for both).Kappa analysis showed the Kappa values were below 0.5 for both boys and girls in general and by age.The GP method values were less than that of the China 05 method(P<0.0001)for males before the age of 10 and females before the age of 9.Assessment results of the two methods were basically the same for females at the age of 9(P>0.05)and the GP method values were greater than that of the China 05 method(P<0.0001)for males and females after the age of 9.The China 05 results were closer to the chronological age for both sexes.Conclusion The consistency between the two methods of bone age assessment is low for normal children and adolescents,and the assessment of maturity status should be combined with other growth indicators.In this sample,the China 05 method was slightly better than the GP method.
作者
蔡广
潘其乐
朱镕鑫
CAI Guang;PAN Qile;ZHU Rongxin(Shanghai Research Institute of Sports Science,Shanghai 200030,China)
出处
《中国循证儿科杂志》
CSCD
北大核心
2020年第6期441-446,共6页
Chinese Journal of Evidence Based Pediatrics
基金
上海市科委定向课题研究项目:18DZ1200600。
关键词
骨龄
GP图谱法
中华05法
发育评估
一致性
Bone age
Greulich-Pyle method
China 05 method
Development assessment
Consistency
