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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳羿貞 | |
dc.contributor.author | Shih-jaw Tsai | en |
dc.contributor.author | 蔡士棹 | zh_TW |
dc.date.accessioned | 2021-06-13T03:49:11Z | - |
dc.date.available | 2007-08-31 | |
dc.date.copyright | 2006-08-31 | |
dc.date.issued | 2006 | |
dc.date.submitted | 2006-07-25 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/32435 | - |
dc.description.abstract | 為了研究臺灣人頸椎骨骼成熟分期(CVM)與手腕骨骼成熟分期(NTUH-SMI)之相關性,709位(330位男性和379 位女性)涵蓋青春期前至成人早期之男女側面測顱影像及手腕骨骼影像納入研究分析,大部分樣本取自台灣大學附設醫院齒顎矯正科檔案資料。由30份分別隨機抽樣選取之側面測顱及手腕骨骼影像作誤差評估。評估者之內誤差值檢驗顯示,前後兩次判讀頸椎骨骼成熟分期與手腕骨骼成熟分期的Spearman rank correlation coefficient值分別為0.998和0.981。而評估者之間判讀頸椎骨骼成熟分期與手腕骨骼成熟分期的Spearman rank correlation coefficient值分別為0.998與介於0.963-0.981之間,顯示這兩種骨骼成熟分期判定都具有高再現性與可靠性。
統計結果顯示在男性以及女性樣本中頸椎骨骼成熟分期與手腕骨骼成熟分期之間有極佳的線性相關,Spearman rank correlation coefficient值分別為0.91及0.937。就臨床實用性而言,以頸椎骨骼成熟分期或是手腕骨骼成熟分期中任一應已足夠判定個體發育情況。 就女性樣本而言,初經來潮年齡與過去研究相比較有下降趨勢。初經來潮在頸椎骨骼成熟分期CS2之後或手腕骨骼成熟分期NTUH-SMI 3(S)之後才會發生。 關鍵字: 骨骼成熟,手骨,頸椎,初經 | zh_TW |
dc.description.abstract | The aim of this study was to investigate the correlation between the latest improved version of cervical vertebral maturation (CVM) method and the National Taiwan University Hospital skeletal maturation indices (NTUH-SMI) among Taiwanese subjects. The samples were derived from lateral cephalograms and hand-wrist radiographs of 709 subjects (330 males and 379 females), mostly from Department of Orthodontics, National Taiwan University Hospital. Hand-wrist radiographs were analyzed using the NTUH-SMI to determine skeletal maturation stage. Images of cervical vertebrae (C2, C3, and C4) obtained from lateral cephalograms were visual-analyzed using the latest improved version of CVM to determine skeletal maturation stage. Intra-examiner and inter-examiner reliability for both methods was calculated from 30 randomly selected hand-wrist and lateral cephalograms. For Intra- examiner reliability, a Spearman rank correlation coefficient value of 0.998 for NTUH-SMI and 0.981 for CVM were obtained. For Inter-examiner reliability, a Spearman rank correlation coefficient value of 0.998 for NTUH-SMI and 0.963- 0.981 for CVM were obtained.
A Spearman rank correlation coefficient value of 0.91 for males and 0.937 for females (P <.001) were found between the skeletal maturation stages of both methods. Correlation values between both skeletal maturation methods were very high. Because of the high correlation coefficients, this study suggested either of the methods could be used clinically as a maturity indicator for the evaluation of individual patients. This study also showed a downward trend in mean age at menarche in Taiwan. The onset of menarche would occur after cervical vertebral maturation stage CS2 was attained or after NTUH-SMI 3(S) was attained. | en |
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dc.description.tableofcontents | 目錄
目錄………………………………………………………………….I 表圖目錄……………………………………………………………V 附表………………………………………………….………… …..V 附圖 ……………………………………………………………… VII 中文摘要………………………………………………………… VIII 英文摘要…………………………………………………………….IX I. 前言……………………………………………………………….…1 II. 文獻回顧…………………………………………………………….4 II-1 手腕骨骼成熟判定之回顧………………………………………..9 II-1-1 The Greulich and Pyle method………………………………….9 II-1-2 The Tanner and Whitehouse method ( TW2 method )………...10 II-1-3 Fishman的骨骼成熟分期研究………………………………..11 II-1-4 台灣大學附設醫院齒顎矯正科之手腕骨骼發育研究….…..14 II-2 頸椎骨骼成熟判定………………………………………………16 II-2-1 Lampaski’s method……………………………………………16 II-2-2 Improved version of CVM…………………………………….17 II-3 手腕骨骼成熟與頸椎骨骼成熟相關性之相關研究……………19 II-3-1國外相關研究…………………………………………………19 II-3-2國內相關研究…………………………………………………21 II-4 女性初經與生長發育……………………………………………22 II-4-1 女性初經與生長發育……………………………………...…22 II-4-2 女性早熟趨勢……………….……………………………..…24 III. 材料與方法………………………………………………………...27 III-1 研究材料…………………………………………..……….……27 III-2 研究方法………………………………….…………………..…29 III-2-1手腕骨骼成熟分期判定....………..…………………….……29 III-2-2 頸椎骨骼成熟分期判定…………………………………….31 III-2-3誤差檢驗……………………………………………………...33 III-2-3-1評估者之內誤差檢驗…………………………………….33 III-2-3-2評估者之間誤差檢驗……………………………………..33 III-3 統計檢定………………………………….. ……………………34 III-4初經年齡統計………………………………….. ……………….35 IV. 研究結果…………………………………………….. ……………36 IV-1誤差值檢驗………………………………………….. ………….36 IV-1-1 手腕骨骼成熟分期(NTUH-SMI )誤差值檢驗……………..36 IV-1-2 頸椎骨骼成熟分期 (CVM) 誤差值檢驗………………….38 IV-2 主研究結果……………………………………………………..40 IV-2-1 手腕骨骼成熟分期…..…………………………...…………40 IV-2-2 頸椎骨骼成熟分期…..………………………...……………41 IV-2-3 變異數分析(ANOVA)與事後比較(Post Hoc test)檢定分 析.…..…………………….. ………………………………...42 IV-2-3-1 男性手腕骨骼成熟分期變異數分析與事後比較檢定…42 IV-2-3-2 女性手腕骨骼成熟分期變異數分析與事後比較檢定…43 IV-2-3-3 男性頸椎骨骼成熟分期變異數分析與事後比較檢定…44 IV-2-3-4 女性頸椎骨骼成熟分期變異數分析與事後比較檢定…45 IV-2-4 手腕骨骼成熟分期與頸椎骨骼成熟分期之關係………….46 IV-2-4-1 男性頸椎骨骼成熟分期與手腕骨骼成熟分期之相關性..…………………….. ………………………………...46 IV-2-4-2 女性頸椎骨骼成熟分期與手腕骨骼成熟分期之相關 性..…………………….. ………………………………...48 IV-2-5 本研究與國內相關研究之比較……………………………..50 IV-2-5-1 男性手腕骨骼成熟分期平均年齡之比較……………....50 IV-2-5-2 女性手腕骨骼成熟分期平均年齡之比較……………....51 IV-2-5-3 男性頸椎骨骼成熟分期平均年齡之比較……………....52 IV-2-5-3 女性頸椎骨骼成熟分期平均年齡之比較…. …………..52 IV-2-6 女性樣本初經年齡相關分析…. …………………………..53 IV-2-6-1 女性樣本初經年齡統計………………………………...53 IV-2-6-2 女性樣本初經年齡與骨骼成熟分期之關係…………...53 IV-2-6-2-1 初經與手腕骨骼成熟分期之關係…. ………………53 IV-2-6-2-2 女性樣本初經年齡與頸椎骨骼成熟分期之關係…...54 V 討論………………………………………………………………….55 V-1手腕骨骼成熟分期與頸椎骨骼成熟分期之評估者誤差值檢驗…………………………………………………………………..55 V-2 手腕骨骼成熟分期…. …………………………………………..57 V-3 頸椎骨骼成熟分期…. …………………………………………..61 V-4手腕骨骼成熟分期與頸椎骨骼成熟分期之相關性…………….63 V- 5本研究女性初經來潮年齡與其他相關研究之比較……………66 V-6 本研究結果之臨床應用性…. …………………………………69 V-6-1二級咬合異常之治療時機…. ………………………………..74 V-6-2三級咬合異常之治療時機…. ………………………………..75 V-7 頸椎骨骼成熟分期判定之缺點…. ……………………………77 VI. 結論... ……………………………………………………………...79 VII. 未來研究方向…. …………………………………………………81 VIII. 參考文獻……. …………………………………………………..83 表圖目錄 附表……………………………………………………………..………94 表1: 樣本人數及性別年齡分布……………………………..………95 表2-a: 手骨骨骼成熟分期之評估者誤差值檢驗I (Wilcoxon Signed Ranks Test) ……………………………………………..………96 表2-b: 頸椎骨骼成熟分期之評估者誤差值檢驗I (Wilcoxon Signed Ranks Test) ……………………………………………..………96 表3-a: 手骨骨骼成熟分期之評估者誤差值檢驗II (Spearman Rank Correlation Coefficient) …………………………………..…….97 表3-b: 頸椎骨骼成熟分期之評估者誤差值檢驗II (Spearman Rank Correlation Coefficient) …………………………………..…….97 表4-a: 手腕骨骼成熟分期之評估者誤差值檢驗III (Kappa analysis)..98 表4-b: 頸椎骨骼成熟分期之評估者誤差值檢驗III (Kappa analysis)..98 表5: 男女性於不同手腕骨骼成熟分期之平均年齡………………... .99 表6: 男女性於不同頸椎骨骼成熟分期之平均年齡………………...100 表7-a: 手腕骨骼成熟分期之年齡因素的ANOVA檢定………….....101 表7-b: 男性手腕骨骼成熟分期之年齡因素的事後檢定分析………101 表7-c: 女性手腕骨骼成熟分期之年齡因素的事後檢定分析………101 表8-a: 頸椎骨骼成熟分期之年齡因素的ANOVA檢定………….....102 表8-b: 男性頸椎骨骼成熟分期之年齡因素的事後檢定分析…..….102 表8-c: 女性頸椎骨骼成熟分期之年齡因素的事後檢定分析……...102 表9-a: 性別-頸椎骨骼成熟分期-手腕骨骼成熟分期分層交叉表...103 表9-b: 頸椎骨骼成熟分期與手腕骨骼成熟分期相關性檢定…….103 表10: 不同研究間男性手腕骨骼成熟分期平均年齡之比較…….…104 表11: 不同研究間女性手腕骨骼成熟分期平均年齡之比較…….…104 表12-a: 男性頸椎骨骼成熟分期平均年齡之比較………………….105 表12-b: 女性頸椎骨骼成熟分期平均年齡之比較………………….105 表13: 初經年齡累計分布情形………………………………………106 表14: 初經-頸椎骨骼成熟分期-手腕骨骼成熟分期分層交叉表…..107 附圖……………………………………………………………………108 圖1: 樣本人數及性別年齡分布……………………………………109 圖2-a: 男性手腕骨骼分期與頸椎骨骼分期關係圖………………..110 圖2-b: 女性手腕骨骼分期與頸椎骨骼分期關係圖………………..110 圖2-c: 男性手腕骨骼分期與頸椎骨骼分期關係圖………………..111 圖2-d: 女性手腕骨骼分期與頸椎骨骼分期關係圖………………..111 圖3-a: 初經來潮年齡分布圖………………………………………...112 圖3-b: 初經來潮年齡累積百分率圖………………………………..112 手腕骨骼成熟指數參考圖譜…………………………………………113 頸椎骨骼成熟指數參考圖譜…………………………………………124 附錄一: 評估者之誤差檢驗…………………………………………132 附錄二: 亂數表與原始資料…………………………………………135 | |
dc.language.iso | zh-TW | |
dc.title | 手腕骨骼與頸椎骨骼成熟相關性
以及女性初潮年齡提早趨勢之探討 | zh_TW |
dc.title | Correlations of skeletal maturation stages assessed by hand-wrist and cervical vertebrae development and trend of early onset of menarche | en |
dc.type | Thesis | |
dc.date.schoolyear | 94-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 劉仁沛 | |
dc.contributor.oralexamcommittee | 姚宗珍 | |
dc.subject.keyword | 骨骼成熟,手骨,頸椎,初經, | zh_TW |
dc.subject.keyword | skeletal maturation,hand-wrist,cervical vertebrae,menarche, | en |
dc.relation.page | 156 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2006-07-26 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床牙醫學研究所 | zh_TW |
顯示於系所單位: | 臨床牙醫學研究所 |
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