女性青少年特发性脊柱侧凸患者生长高峰预测因素的组织学评价

目的通过组织学研究来评价青少年特发性脊柱侧凸女性患者生长高峰预测因素的价值。方法收集青少年特发性脊柱侧凸女性患者的髂软骨标本,垂直钙化层进行切片染色,并对其增殖活性进行分级。将患者年龄、月经、腕骨骨龄、肘关节骨龄、指骨骨龄及Risser征进行分级,比较各级间患者髂软骨增殖活性的差异。结果共收集53例患者骨标本,平均年龄14．0岁。通过组织学分析发现年龄〉13．0岁、月经来潮、腕骨骨龄〉14．0岁及Risser征Ⅲ级的患者增殖活性下降。结论年龄〉13．0岁、月经来潮、腕骨骨龄〉14．0及Risser征Ⅲ级均可用于判定青春期生长高峰结束;年龄11．0岁、乳房开始发育、腕骨骨龄12岁可用于预测PHV的开始。

The value of parameters in predicting the growth peak height velocity of the adolescent idiopathic scoliosis girls: a histomorphological study on iliac crest cartilage

OBJECTIVE: To evaluate the value of some parameters in predicting of growth peak height velocity (PHV) of the girls with adolescent idiopathic scoliosis (AIS) by histomorphological studying on iliac crest cartilage. METHODS: Iliac crest cartilages were harvested during posterior surgery from girls with AIS. The samples were then paraffin embedded after stored in formalin solid over 24 hours, sectioned vertical to the calcification at the thickness of 5 microm, and stained with Hematoxylin and Eosin. The histological grading of the proliferating activity of it was observed under the microscope. Parameters included chronologic age, menarche status, wrist skeletal age, digital skeletal age, elbow epiphysis and Risser sign were recorded. The histological grading data were compared with these parameters in terms of their accuracy in the prediction of PHV of the scoliosis. RESULTS: The specimens of 53 AIS patients with an average age 14.0 years were stained successfully. The proliferating activity of the iliac crest cartilage decreased when the AIS girl was over 13.0 years of chronologic age, 14.0 years of wrist skeletal age, post menarche or Risser sign was no less than grade 3. CONCLUSIONS: All the parameters evaluated can be used to show the end of PHV. Three parameters, including 11 years old of chronologic age, 12 years of the wrist skeletal age, unfusion of the elbow epiphysis and the thelarche, can be used in predicting the beginning of PHV.