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目的:了解拉萨市藏族青少年手腕部和膝部长骨发育情况,分析拉萨市藏族青少年长骨干骺融合时间是否存在性别差异,不同性别间长骨干骺融合率是否存在年龄差异及与平原地区(新疆哈萨克族、辽宁省开原市)青少年干骺融合时间的对比情况。方法:于2003-07/2003-09采用分层整群抽样的方法选取拉萨市藏族14～22岁青少年868人(男440人,女428人),均自愿参加且无手腕部和膝部损伤史。利用摄片法拍摄手腕部和膝部X片,观察其干骺融合情况。计算长骨干骺融合年龄。长骨干骺融合年龄采用均数±标准差和中位数表示。结果:按意向处理分析,拉萨市藏族14～22岁青少年868人均进入结果分析。①拉萨市藏族青少年长骨干骺融合时间:男性桡骨远端为20.27(20.22±1.24)岁,股骨下端为19.39(18.90±1.55)岁,胫骨上端为(19.12±1.39)19.48岁,腓骨上端为19.95(19.62±1.42)岁;女性则分别为(18.99±1.30)19.26,(17.06±1.29)17.17,(18.13±1.67)18.18和(18.38±1.57)18.55岁(括号外数字为中位数)。②桡骨远端干骺半数融合时间:男性在19～20岁,女性在18～19岁。③股骨下端干骺半数融合时间:男性在17～18岁,女性在15～16岁。④胫骨上端干骺半数融合时间:男性在17～18岁,女性在15～16岁。⑤腓骨上端干骺半数融合时间:男性在18～19岁,女性在16～17岁。⑥拉萨藏族青少年桡骨远端干骺融合时间及膝部各长骨干骺大部分融合时间均晚于新疆哈萨克族和辽宁省开原市农村青少年。结论:①在进行性别比较时发现,拉萨市藏族青少年手腕部和膝部长骨的干骺融合时间都呈现女性早于男性,说明女性骨发育到成熟比男性早。②拉萨市藏族青少年手腕部和膝部各长骨干骺融合顺序从早到晚依次为:股骨、胫骨、腓骨、桡骨。③拉萨市藏族青少年相对于平原青少年,其融合时间总体延迟。④中位数的方法所得出的干骺融合时间比均数±标准差方法所得时间晚。
OBJECTIVE: To understand the development of long bones of wrist and knee in adolescent adolescents in Lhasa, to analyze whether there are gender differences in the time of metaphysis of long bones of young adolescents in Lhasa, whether there is age difference in the metaphase fusion rates of long bones among different sexes, Tribe, Kaiyuan City, Liaoning Province) young people metaphyseal fusion time comparison. Methods: From July 2003 to September 2003, stratified cluster sampling method was used to select 868 Tibetan adolescents aged 14 to 22 in Lhasa (440 males and 428 females) who participated voluntarily without wrist and knee injuries history. Shooting the wrist and knee X-ray film, observe the metaphyseal fusion. Calculate the long bone metaphyseal fusion age. Long bony epiphyseal fusion age using mean ± standard deviation and median. Results: According to the analysis of intention-to-treat, 868 per capita adolescents aged 14 to 22 in Lhasa were involved in the result analysis. (1) The duration of metaphyseal fusion of long bone of Tibetan adolescents in Lhasa was 20.27 (20.22 ± 1.24) years old, 19.39 (18.90 ± 1.55) years old, 19.48 years old (19.12 ± 1.39) years old and 19.95 (19.62 ± 1.42) years old, while those in females were (18.99 ± 1.30) 19.26, (17.06 ± 1.29) 17.17, (18.13 ± 1.67) 18.18 and (18.38 ± 1.57) 18.55 years, respectively. ② distal radius of metaphyseal half fusion time: men in 19 to 20 years of age, women in 18 to 19 years of age. ③ distal femoral epiphyseal half fusion time: men in 17 to 18 years old, women in 15 to 16 years old. ④ distal tibia metaphyseal half fusion time: men 17 to 18 years old, women in 15 to 16 years old. ⑤ fibula distal metaphyseal half fusion time: men in 18 to 19 years old, women in the 16 to 17 years old. ⑥The distal radius metaphysis fusion time of Lhasa Tibetan adolescents and the metaphysis of the long bones of most of the knees lasted later than the Kazakh adolescents from Xinjiang and Kaiyuan City, Liaoning Province. Conclusions: ① In the comparison of gender, it was found that the time of metaphyseal fusion between wrist and knee long bones of Tibetan adolescents in Lhasa was earlier than that of men, indicating that the female bone development to maturity earlier than men. ② Lhasa Tibetan adolescent wrist and knee long epiphyseal fusion sequence from morning to night were: the femur, tibia, fibula, radius. ③ Lhasa Tibetan adolescents compared with plain adolescents, the integration of the overall delay. ④ The median epiphyseal fusion method obtained by the method of time than the mean ± standard deviation of the time obtained.