法医学杂志

法医学杂志 ›› 2010, Vol. 0 ›› Issue (3): 181-184.

• 论文 • 上一篇    下一篇

TW2法3种标准用于中枢性性早熟患儿骨龄推断的比较

白万晶;宁刚;曲海波;孙小妹;向承发;吴康敏;刘关键;   

  1. 四川大学华西第二医院;四川大学华西临床医学院;
  • 发布日期:2010-06-25 出版日期:2010-06-28

Comparison among Three Standards of TW2 to Skeletal Age Determination in Children with Central Precocious Puberty

BAI WAN-JING1,NING GANG1,QU HAI-BO1,SUN XIAO-MEI1,XIANG CHENG-FA1,WU KANG-MIN1,LIU GUAN-JIAN2(1.WEST CHINA SECOND HOSPITAL,SICHUAN UNIVERSITY,CHENGDU 610041,CHINA;2.WEST CHINA SCHOOL OF CLINICAL MEDICINE,SICHUAN UNIVERSITY,CHENGDU 610041,CHINA)   

  • Online:2010-06-25 Published:2010-06-28

被引次数

3

摘要： 目的探讨TW系列骨龄评分法中TW2(英国人标准)、TW2-CHN(中国人标准)和TW2-JP(日本人标准)3种标准对中枢性性早熟(central precocious puberty,CPP)患儿骨龄评价的诊断价值,以及正常值临界点的确定。方法选取确诊为CPP的病例组61例;对照组67例,其中同龄正常儿童61例,另6例为特殊对照组。两名医师独自阅每一对象左手腕部X线片,分别用3种标准测定骨龄;将骨龄与生理年龄的差值(d)用SPSS 13.0进行ROC分析。结果 (1)两名医师骨龄测定结果的κ值为0.776(u=16.128,P<0.05);(2)TW2、TW2-CHN及TW2-JP 3种标准测得的ROC曲线下面积两两之间的差异无统计学意义;(3)TW2中d≥1.15岁、TW2-CHN中d≥1.25岁与TW2-JP中d≥0.65岁为敏感度、特异度都较高的点。结论 TW2、TW2-CHN及TW2-JP 3种标准对CPP患儿骨龄评价的诊断价值都较高,其中TW2-CHN对中国儿童的诊断价值最大。

关键词: 法医学, 年龄测定, 骨骼, 青春期, 早熟, TW2法

Abstract: Objective To discuss the diagnostic value of English,Chinese and Japanese standards of TW2 to skeletal age assessment of children with central precocious puberty(CPP),then to confirm the normal thresholds.Methods Sixty one children as patient group were definitely assured CPP.The control group had 67 children.Among them,61 were normal children,another 6 children as a special control group.Left hand-wrist X-ray radiographs were retrospectively analyzed by two doctors separately and their skeletal ages were assessed with the three standards of TW2 method.The differences between skeletal age and chronological age were analyzed with ROC in SPSS 13.0.Results(1) The skeletal age results showed κ value is 0.776 deduced by two clinical doctors(u=16.128,P<0.05).(2) There were no statistic differences for the areas under ROC curves among three methods.(3) d≥1.15 years in TW2,d≥1.25 years in TW2-CHN and d≥0.65 years in TW2-JP were more susceptive and specific points.Conclusion TW2,TW2-CHN and TW2-JP provided a higher value for the diagnosis of skeletal age in unhealthy children,and TW2-CHN is highest value for Chinese children.

Key words: forensic medicine, age determination by skeleton, puberty, precocious, TW2 method