儿童矮小症45例病因和治疗分析

Clinical study on 45 children with dwarfism

目的探讨儿童矮小症的病因,为临床诊断治疗提供参考依据。方法对45例儿童矮小症病例,进行回顾性分析。结果 45例矮小症儿童中,生长激素(GH)缺乏性矮小14例,特发性家族性矮小9例,体质性矮小9例,小于胎龄儿7例,染色体异常2例,甲状腺功能减退1例,幼年特发性关节炎1例,营养缺乏2例。重组人生长激素(rh-GH)对生长激素缺乏症(GHD)、特发性矮小和足月小样儿治疗效果满意,身高增长1 cm/月左右,非GH缺乏甲状腺功能低下予以甲状腺素片治疗,身高增长迅速。结论儿童矮小症病因复杂,以GHD最多见,必须全面询问和采集病史,做相关实验室检查,明确病因,以利治疗。

Objective To study the etiological factors for children with dwarfism,and to provide reference for its clinical diagnosis and treatment.Methods The clinical data of 45 children met with the criteria for dwarfism were retrospectively analyzed.Results Among these 45 cases of children with dwarfism,14 cases were diagnosed as growth hormone deficiency（GHD）,9 cases with idiopathic familial dwarfism,9 with physique dwarfism,7 with smaller gestational age,2 with chromosomal abnormality,1 with hypothyroidism,1 with juvenile idiopathic arthritis and 2 with malnutrition.Recombinant human growth hormone（rhGH） was effective in treatment of GHD,ISS and IUGR（intrauterine growth retardation）,and the mean height increased about 1cm/month after treatment.The same curative effect could be gained in hypothyroidism and non-GHD cases after treatment with thyroid tablets.Conclusion Etiology of children dwarfism is complex.Growth hormone deficiency is the most common etiological factor.Patients should be inquired for all possible etiological factors and all possible medical histories must be collected.Related laboratory examinations should be done.Accurate diagnosis of etiology is important for treatment.