中国0～18岁儿童、青少年身高、体重的标准化生长曲线

目的 研究制定中国0～18岁儿童、青少年身高、体重的生长参照值及标准化生长曲线,供儿科临床及预防保健工作使用.方法 采用"2005年中国九市7岁以下儿童体格发育调查"及"2005年中国学生体质健康调研"中九省市94 302名0～19岁(差1天未满19岁)城区健康儿童青少年的身高(3岁以下测量身长)、体重测量数据,应用LMS方法对数据进行拟合修匀,获得所需要的百分位和标准差单位(Z分值)数值并绘制相应的曲线图.结果 制定出0～18岁男、女儿童各自的年龄的体重、年龄的身高第3、10、25、50、75、90及97百分位及-3、-2、-1、0、+1、+2、+3倍标准差(SD)单位曲线图.与世界卫生组织(WHO)新的生长标准及美国疾病预防控制中心(CDC)2000年(CDC2000)标准进行比较,三者之间存在差异.男童15岁、女童13岁之前,中国儿童身高略高于美国及WHO标准,之后逐渐低于美国及WHO标准,18岁时男童身高低于美国3.5 cm,女童低于美国2.5 cm;体重在学龄期后差异明显,18岁时中国男童低于美国平均约5.9 kg,女童差别更大,8～18岁间差值约4.1～20.5 kg.结论 该套身高、体重标准图表具有国家代表性、年龄完整,可作为中国儿童青少年的生长参照标准在儿科临床及公共卫生领域中使用,有利于生长异常的早期识别、疾病的诊断以及治疗效果的评价.

Height and weight standardized growth charts for Chinese children and adolescents aged 0 to 18 years

Objective To construct the height and weight growth charts for Chinese children and adolescents from birth to 18 years for both clinical and preventive health care uses.Methods Data from two national representative cross.sectional surveys which were The National Growth Survey of Children under 7 years in the Nine Cities of China in 2005 and The Physical Fitness and Health Surveillance of Chinese school Students in 2005.The data from 94 302 urban healthy children were used to set up the database of length/height(length was measured for children under 3 years)and weiight The LMS method was used to smooth the growth curves,with estimates of L.M,and S parameters,values of percentile and Z-score curves which were required were calculated,and then generated standardized growth charts.Results The 3rd,10th,25th,50th,75th,90th,97th smoothed percentiles curves and -3,-2,-1,0,+1,+2,+3 Z-scores curves of weight-for-age,length/height-for-age for boys and girls aged 0-18 years were made out respectively.Comparison with the new WHO growth charts and 2000 CDC growth charts for the United States,the results showed that tllere was some big difference in weight and height among the three growth charts.For boys under 15 years of age and girls under 13 years of age,the China curves are slightly higher than WHO and CDC curves,but after those ages,the China curves fall behind and the difference became larger as age progresses.At the age of 18 years,the Chinese children are 3.5 cm shorterin boys and 2.5 cm shorter in girls as compared with the U.S children.The difference in weights are very large for the school children,especially in girls.The weight of Chinese boys was 5.9 kg less than that of the U.S.boys at 18 years,and the difference was much bigger in girls,the weight of U.S.girls between 8 to 18 years was 4.1-20.5 kg more than that of Chinese girls at the sslne age range.Conclusion The new growth charts of height and weight were based on national survey data and therefore are recommended as the China national growth standards for use in pediatric clinics and public health service.Application of the charts will promote child growth monitoring,discovering early growth disorder,and will be useful to diagnosis of diseases and assessment of therapeutic effects.