大骨节病x线征指关节指畸形演变过程

通过对2～3岁123例大骨节病儿和84例病区健康儿4年连续观察发现,123例大骨节病儿中有100例(81.3%)有干骺端改变,其中1～4年干骺端自愈率分别为22%、43%、57.8%、73.6%,头两年内自愈者占自愈人数的76.8%,2～6岁自愈率为92.9%,7～10岁为66.7%,11～13岁为20.5%,有骨端改变者81例(66.9%),4年观察中骨端无1例自愈,好转者仅6例(7.4%),不变者31例(38.2%),恶化者44例(54.4%),近端指间关节与指宽比值异常者31例(25.2%),其中12例持续不变,2例转为正常,17例由正常变为异常;指长与掌宽比值异常者有2例,无新异常者发生。84例健康儿近端指关节与指宽比值、指长与掌宽比值均正常,也无新异常者发生。由以上结果可见,干骺端自愈率高,速度快,骨端无自愈者,好转率也低,二者作为观察指标均存在一定问题,作者认为,干骺端作为评价防治效果指标最好设内对照,并需其它指标作佐证,而近端指关节与指宽比值可能是这方面的定量性参考指标之一。

THE NATURAL DEVELOPING PROCESS OF X-RAY MANIFESTATION IN CHILDREN WITH KASHIN-BECK DISEASE

123 children with Kashin- Beck disease (KBD) and 84 normal children at the age of 2-13 in the KBD-affecter area have been continuously investigated for 4 years. It was found that 83% of KBD children had metaphyseal lesions and 66.9% of them had lesions in bone ends, and that the natural recovering rate of metaphyseal lesions from the 1st year to the 4th year was 22%, 43%, 57.8% and 73.6% respectively, and the natural recovely to the lesions of bone end was not found in all cases. It was also found that 25.2% of KBD children had an abnormal ratio of finger joint width and fingerwidth. Among them,2 changed from abnormal to normal and 17 from normal to abnormal. Only 2 children had an abnormal ratio of finger length and hand width. All the 84 normal children in the KBD-affected area had normal ratio of two ratios. No new case whose ratio turnd abnomal was found in 4 years. Our observations suggest that it is not reasonable to take the varying rate of metaphyseal lesions as the only evaluating criteria of cure and prevention of KBD because the natural recoveing rate of metaphyseal lesions is very high. It seems to be more reliable to combine the varying rate of metaphyseal leisions with the ratio of finger joint width and figer width as the evaluating criteria of cure and prevention of KBD.