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。
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,P0.05）.（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.
出处
《法医学杂志》
CAS
CSCD
2010年第3期181-184,共4页
Journal of Forensic Medicine
关键词
法医学
年龄测定
骨骼
青春期
早熟
TW2法
forensic medicine
age determination by skeleton
puberty
precocious
TW2 method
