中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2014年
11期
843-846
,共4页
先天性房间隔缺损%肺动脉高压%缺损口大小%生长发育%骨龄指数
先天性房間隔缺損%肺動脈高壓%缺損口大小%生長髮育%骨齡指數
선천성방간격결손%폐동맥고압%결손구대소%생장발육%골령지수
Congenital atrial septal defect%Pulmonary hypertension%Defect size%Growth and development%Bone age index
目的 探讨先天性房间隔缺损(ASD)患儿体格、骨龄变化及心脏结构和功能改变与骨龄指数(BAI)的相关性.方法 确诊ASD患儿48例为实验组,健康体检儿童30例为健康对照组,2组均测量身高、体质量.采用Philips ie33型超声诊断仪检测各项心脏结构和功能指标,Philips数字X光机摄左手及腕关节正位片,应用最新《中国儿童骨龄评分法》图谱进行骨龄评定,并计算BAI.14例行ASD修补术的ASD患儿术中测量缺损口面积.分析实验组与对照组儿童体格发育及骨龄的差异,分别将实验组各项心脏结构和功能指标、缺损口面积与BAI进行直线相关性分析.结果 2组年龄、身高、骨龄比较差异均无统计学意义(t=-0.02,-1.31,-1.69,P均＞0.05),体质量、BAI比较差异均有统计学意义(t=-2.28,-9.06,P均＜0.05);不同肺动脉收缩压(PASP) ASD患儿的身高、体质量、BAI比较差异均有统计学意义(F=27.630,23.537,16.704,P均＜0.01);不同缺损口大小的ASD患儿年龄、体质量比较差异均无统计学意义(t=-1.218,-0.046,P均＞0.05),而身高、BAI比较差异均有统计学意义(t=2.561,2.191,P均＜0.05);ASD患儿年龄与BAI无相关性(r=-0.175,P＞0.05),缺损口大小、缺损口大小/房间隔伸展径、PASP与BAI均呈负相关(r=-0.349,P＜0.05;r=-0.412,P＜0.01;r=-0.539,P＜0.01);14例ASD患儿缺损口面积与缺损口大小呈正相关(r=0.599,P＜0.05),与BAI呈负相关(r=-0.655,P＜0.05).结论 ASD患儿体格发育落后于正常儿童,以体质量落后明显;ASD患儿BAI亦显著落后于正常儿童,即骨骼生长速率显著落后于正常同龄儿;ASD患儿体格发育及骨龄落后程度与PASP、缺损口大小相关;PASP对身高影响较大,缺损口大小对身高、体质量均有影响;实际年龄即病程长短与体格发育及骨龄无相关性.
目的 探討先天性房間隔缺損(ASD)患兒體格、骨齡變化及心髒結構和功能改變與骨齡指數(BAI)的相關性.方法 確診ASD患兒48例為實驗組,健康體檢兒童30例為健康對照組,2組均測量身高、體質量.採用Philips ie33型超聲診斷儀檢測各項心髒結構和功能指標,Philips數字X光機攝左手及腕關節正位片,應用最新《中國兒童骨齡評分法》圖譜進行骨齡評定,併計算BAI.14例行ASD脩補術的ASD患兒術中測量缺損口麵積.分析實驗組與對照組兒童體格髮育及骨齡的差異,分彆將實驗組各項心髒結構和功能指標、缺損口麵積與BAI進行直線相關性分析.結果 2組年齡、身高、骨齡比較差異均無統計學意義(t=-0.02,-1.31,-1.69,P均＞0.05),體質量、BAI比較差異均有統計學意義(t=-2.28,-9.06,P均＜0.05);不同肺動脈收縮壓(PASP) ASD患兒的身高、體質量、BAI比較差異均有統計學意義(F=27.630,23.537,16.704,P均＜0.01);不同缺損口大小的ASD患兒年齡、體質量比較差異均無統計學意義(t=-1.218,-0.046,P均＞0.05),而身高、BAI比較差異均有統計學意義(t=2.561,2.191,P均＜0.05);ASD患兒年齡與BAI無相關性(r=-0.175,P＞0.05),缺損口大小、缺損口大小/房間隔伸展徑、PASP與BAI均呈負相關(r=-0.349,P＜0.05;r=-0.412,P＜0.01;r=-0.539,P＜0.01);14例ASD患兒缺損口麵積與缺損口大小呈正相關(r=0.599,P＜0.05),與BAI呈負相關(r=-0.655,P＜0.05).結論 ASD患兒體格髮育落後于正常兒童,以體質量落後明顯;ASD患兒BAI亦顯著落後于正常兒童,即骨骼生長速率顯著落後于正常同齡兒;ASD患兒體格髮育及骨齡落後程度與PASP、缺損口大小相關;PASP對身高影響較大,缺損口大小對身高、體質量均有影響;實際年齡即病程長短與體格髮育及骨齡無相關性.
목적 탐토선천성방간격결손(ASD)환인체격、골령변화급심장결구화공능개변여골령지수(BAI)적상관성.방법 학진ASD환인48례위실험조,건강체검인동30례위건강대조조,2조균측량신고、체질량.채용Philips ie33형초성진단의검측각항심장결구화공능지표,Philips수자X광궤섭좌수급완관절정위편,응용최신《중국인동골령평분법》도보진행골령평정,병계산BAI.14례행ASD수보술적ASD환인술중측량결손구면적.분석실험조여대조조인동체격발육급골령적차이,분별장실험조각항심장결구화공능지표、결손구면적여BAI진행직선상관성분석.결과 2조년령、신고、골령비교차이균무통계학의의(t=-0.02,-1.31,-1.69,P균＞0.05),체질량、BAI비교차이균유통계학의의(t=-2.28,-9.06,P균＜0.05);불동폐동맥수축압(PASP) ASD환인적신고、체질량、BAI비교차이균유통계학의의(F=27.630,23.537,16.704,P균＜0.01);불동결손구대소적ASD환인년령、체질량비교차이균무통계학의의(t=-1.218,-0.046,P균＞0.05),이신고、BAI비교차이균유통계학의의(t=2.561,2.191,P균＜0.05);ASD환인년령여BAI무상관성(r=-0.175,P＞0.05),결손구대소、결손구대소/방간격신전경、PASP여BAI균정부상관(r=-0.349,P＜0.05;r=-0.412,P＜0.01;r=-0.539,P＜0.01);14례ASD환인결손구면적여결손구대소정정상관(r=0.599,P＜0.05),여BAI정부상관(r=-0.655,P＜0.05).결론 ASD환인체격발육락후우정상인동,이체질량락후명현;ASD환인BAI역현저락후우정상인동,즉골격생장속솔현저락후우정상동령인;ASD환인체격발육급골령락후정도여PASP、결손구대소상관;PASP대신고영향교대,결손구대소대신고、체질량균유영향;실제년령즉병정장단여체격발육급골령무상관성.
Objective To investigate the changes in physique and the bone age,and the correlation between the changes in cardiac structure and function and the bone age index (BAI) in atrial septal defect (ASD) children.Methods The experimental group included 48 cases of ASD patients,and 30 cases of healthy children were assigned as the control group;the children of both groups were measured for height and weight.Philips ie33 ultrasonic detector was used to detect the indicators of cardiac structure and function,and Philips digital X-ray machine was used to radiograph the left hand and the wrist.Then the bone age was assessed in order to calculate the BAI.Fourteen cases of ASD patients who underwent repairing surgery were measured for orifice area in surgery.The differences in physique and the bone age between the 2 groups were analyzed,and Pearson correlation analysis method was used to observe the correlation between the cardiac structure and function indicators,defect area and BAI in the experimental group.Results There was no significant difference in the age,height,bone age (t =-0.02,-1.31,-1.69,all P ＞ 0.05),while the weight and BAI were significantly different between the 2 groups (t =-2.28,-9.06,all P ＜ 0.05).The height,weight and BAI were significantly different in different pulmonary artery systolic pressure (PASP) patients (F =27.630,23.537,16.704,all P ＜ 0.01),while the age and weight had no difference (t =-1.218,-0.046,all P ＞ 0.05).The height and BAI were significantly different in patients with different defect size(t =2.561,2.191,all P ＜ 0.05).There was no correlation between the age and the BAI in children with ASD(r =-0.175,P ＞ 0.05).The defect size,defect size/atrial septal stretched diameter,PASP were all negatively correlated with BAI (r =-0.349,P ＜ 0.05 ; r =-0.412,P ＜0.01 ;r =-0.539,P ＜0.01).The defect area was positively related to the defect size in 14 cases of children with ASD underwent surgery (r =0.599,P ＜ 0.05),and the defect area was negatively correlated with BAI (r =-0.655,P ＜ 0.05).Conclusions The physical development in ASD patients evidently lagged behind the healthy children,particularly for weight.The BAI of ASD patients is significantly smaller than that of the healthy children,in other words,the growing speed of bone in ASD patients is significantly slower than that of the healthy children at the same age.The lagging extent of physical development and the bone age are related to the PASP and defect size.PASP has more influence on the height,yet the defect size has influence on height and weight of ASD children.There is no correlation between physical development and the bone age with the course of disease.
