骨骺闭合时间变化及其影响因素
Changes of Epiphyseal Closing Time and Its Influencing Factors

目的：了解近50年中国地区青少年骨骺闭合趋势，探讨影响骨骺闭合时间变化的因素。为评估儿童及青少年骨龄方法提供参考。方法：通过利用中国知网数据库，检索有关骨骺闭合时间及影响骨骺闭合因素为关键词的文献，对不同的地区进行筛选，主要选择以民族是汉族为研究对象的实验报告进行总结，整理了1963~2010年青少年股骨远端、胫骨近端、腓骨近端、胫骨远端、腓骨远端骨骺闭合年龄数据，统计分析骨骺闭合趋势。结果：五个位点的骨骺闭合均有提前的趋势，其中胫骨远端和腓骨远端闭合较早，女性骨骺闭合普遍比男性较早，提示有必要更新骨龄评估系统。结论：随着时代的发展，儿童和青少年受到激素水平(主要为性激素和甲状腺激素)、营养状况、地域因素等条件的影响，使骨骼发育加快，骨骺闭合提前，该实验对骨骺闭合推断实际年龄的标准更新具有指导意义。
Objective: To understand the trend of epiphyseal closure in adolescents in China in the past 50 years, and to explore the factors that affect the changes in the time of epiphyseal closure. Provide reference for the method of assessing the bone age of children and adolescents. Methods: By using the China HowNet database to search the literature on the time of epiphyseal closure and the factors affecting the closure of the epiphysis as keywords, different regions were screened, and the experimental reports whose ethnicity was the Han nationality as the research object were mainly selected for summary of the age of closure of the distal femur, proximal tibia, proximal fibula, distal tibia, and distal fibula in adolescents in 1963~2010, and statistical analysis of the trend of epiphyseal closure. Results: The closure of the epiphyses at the five sites all tended to be advanced. The distal tibia and the distal fibula closed earlier, and the epiphyseal closure of women was generally earlier than that of men, suggesting that it is necessary to update the bone age assessment system. Conclusion: With the development of the times, children and adolescents are affected by hormone levels (mainly sex hormones and thyroid hormones), nutritional status, geographical factors and other conditions, which accelerate the development of bones and advance the closure of the epiphyses. This experiment infers the actual age of the closure of the epiphyses. The updated standards are instructive.