儿童生长曲线的发展历程、构建方法与应用

doi:10.12372/jcp.2026.25e0686

临床儿科杂志 ›› 2026, Vol. 44 ›› Issue (4): 373-380.doi: 10.12372/jcp.2026.25e0686

• 文献综述 • 上一篇

儿童生长曲线的发展历程、构建方法与应用

高雨霏¹^,^*, 钱耐思²^,^*, 杨之雨², 晋珊², 陆慧萍³, 吴骋⁴, 宋花玲¹(), 虞慧婷²()

1.上海中医药大学公共健康学院（上海 201203）
2.上海市疾病预防控制中心疾病预防控制信息所（上海 201107）
3.上海市松江区疾病预防控制中心（上海 201620）
4.海军军医大学卫生勤务系（上海 200433）

收稿日期:2025-06-16 录用日期:2026-02-12 出版日期:2026-04-15 发布日期:2026-03-31
通讯作者: 宋花玲电子信箱：99SHL@163.com，虞慧婷电子信箱：yuhuiting@scdc.sh.cn
作者简介:^*具有同等贡献
基金资助:
国家自然科学基金项目(82003486);上海市“科技创新行动计划”技术标准项目(22DZ2206000);上海市加强公共卫生体系建设三年行动计划（2023—2025年）重点学科建设项目(GWVI-11.1-31);松江区科技攻关项目(2023SJKJGG022)

Child growth curves: historical development, construction methodologies, and applications

GAO Yufei¹^,^*, QIAN Naisi²^,^*, YANG Zhiyu², JIN Shan², LU Huiping³, WU Cheng⁴, SONG Hualing¹(), YU Huiting²()

1. School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
2. Institute of Disease Control and Prevention Information, Shanghai Municipal Center For Disease Control & Prevention, Shanghai 201107, China
3. Shanghai Songjiang District Center for Disease Control and Prevention, Shanghai 201620, China
4. Department of Health Services, Naval Medical University, Shanghai 200433, China

Received:2025-06-16 Accepted:2026-02-12 Published:2026-04-15 Online:2026-03-31

摘要/Abstract

摘要：

生长曲线是儿童保健和儿科临床中用于动态监测儿童生长发育的重要工具。本文回顾了生长曲线200多年的发展历程，从18世纪的手绘记录到现代的精细化建模，生长曲线已成为评估儿童健康的关键技术。中国在生长曲线研究方面已取得一定进展，本土化生长曲线更符合国内儿童的生长特点，尤其在评估农村儿童生长迟缓方面具有显著优势。文章介绍了生长曲线的构建方法，包括非参数方法（如三次样条法、惩罚样条法、核估计法、局部加权散点回归平滑法）和参数方法（如LMS法和GAMLSS法），并比较了这些方法的优势、局限性和适用场景。未来研究将聚焦于个体化生长曲线的制定以及本土化标准的构建，提高评估的精准性，以更好地服务于儿童健康监测和疾病预防，促进儿童健康。

关键词: 生长曲线, 儿童生长发育, 生长监测

Abstract:

Growth curves are indispensable for monitoring children's growth in child health care and pediatrics. In our article, we traces growth curves ranging over 200 years, from the hand-drawn charts in the early 18th century to algorithmic modeling in modern ages, highlighting their crucial role in assessing child health. China has made progress in growth curves research, with localized versions better reflecting domestic children's growth patterns, especially in detecting growth retardation in rural populations. In this article we also introduce growth curves construction methods, including non - parametric approaches (e.g., cubic spline, penalized splines, kernel estimation, LOWESS/LOESS) and parametric approaches (e.g., LMS, GAMLSS), comparing their merits, limitations, and applicability. Future research will focus on creating individualized growth curves and building localized standards to enhance assessment accuracy, thereby better supporting child health monitoring and disease prevention.

Key words: growth curves, child growth and development, growth monitoring

中图分类号:

高雨霏, 钱耐思, 杨之雨, 晋珊, 陆慧萍, 吴骋, 宋花玲, 虞慧婷. 儿童生长曲线的发展历程、构建方法与应用[J]. 临床儿科杂志, 2026, 44(4): 373-380.

GAO Yufei, QIAN Naisi, YANG Zhiyu, JIN Shan, LU Huiping, WU Cheng, SONG Hualing, YU Huiting. Child growth curves: historical development, construction methodologies, and applications[J]. Journal of Clinical Pediatrics, 2026, 44(4): 373-380.

图/表 2

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方法	优势	局限性	适用场景
三次样条法	（1）无需分布假设；（2）适合处理复杂的非线性关系	只反映平均趋势，百分位数需估计	适用于数据点较为密集且分布均匀的情况
LMS法	（1）沿用百分位数法，结果直观且便于解释；（2）支持Z值转换，提高不同个体、群体间差异的可比性；（3）各相邻百分位数值间不会出现交叉、颠倒或重叠，提高了正常值或标准的精确性	分布假设局限，协变量处理缺乏灵活性	广泛用于人体测量数据的生长曲线建模，尤其是在需要考虑偏度和构建百分位数曲线时
GAMLSS法	（1）多参数建模，对中位数、标准差、偏度系数和峰度系数等四阶矩进行建模，提供更全面的曲线描述；（2）兼容多种分布，适应复杂数据形态，灵活性强；（3）支持多协变量及非参数平滑项	需较大样本量，复杂模型收敛困难	适用于具有明显偏度和峰度特征或有多个协变量等结构复杂的数据，如特殊人群生长曲线

儿童生长曲线的发展历程、构建方法与应用

Child growth curves: historical development, construction methodologies, and applications

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