重庆万州地区矮身材儿童病因及骨龄调查

Survey of skeletal age and etiology of children with short stature in Chongqing Wanzhou area

目的评估重庆万州地区儿童矮身材病因及骨龄状况,为该地区矮身材诊断与治疗提供参考。方法收集祖籍为重庆万州地区的儿童矮身材病例资料347例,回顾分析其病因及骨龄特点。结果矮身材病例中,特发性矮小128例(36.89%),生长激素缺乏症56例(16.14%),体质性青春发育延迟53例(15.27%),家族性矮小50例(14.41%),性早熟28例(8.07%),其余营养性矮小、甲状腺功能低下、软骨发育不良、肾小管酸中毒、先天性卵巢发育不全(Turner综合征)、早产儿、宫内发育迟缓等病因共32例(9.22%)。骨龄呈早熟型11例,正常型108例,晚熟型228例,该组病例骨龄与生活年龄差异有统计学意义(t=-17.157,P=0.000)。特发性矮小(P=0.000)、生长激素缺乏症(P=0.000)、体质性青春发育延迟(P=0.000)、甲状腺功能低下(P=0.000)、软骨发育不良(P=0.002)、Turner综合征(P=0.003)骨龄落后方面差异有统计学意义,性早熟骨龄提前(P=0.022)方面差异有统计学意义。结论特发性矮小、生长激素缺乏症、体质性青春发育延迟、家族性矮小、性早熟为重庆万州地区儿童矮身材主要原因。矮身材儿童骨龄总体滞后。该地区特发性矮小、生长激素缺乏症、体质性青春发育延迟、甲状腺功能低下、软骨发育不良、Turner综合征骨龄落后有统计学意义,性早熟骨龄提前有统计学意义。

Objective To evaluate the cause and skeletal age of children with short stature in Chongqing Wanzhou area to provide a reference for the diagnosis and treatment of short stature in this region .Methods The da‐ta in 347 children with short stature in Chongqing（ancestral home） Wanzhou area were collected and their etiologies and skeletal ages were the retrospectively analyzed .Results Among the cases of short staure ,128 cases were idio‐pathic short stature（36 .89% ） ,56 cases（16 .14% ） were growth hormone deficiency ,53 cases（15 .27% ）were constitu‐tional delay of growth and puberty ,50（14 .41% ） cases were familial short stature ,28 cases（8 .07% ） were precocious puberty ,in the rest of 32 cases（9 .22% ） ,the etiologies included nutritional grow th retardation ,hypothyroidism ,carti‐lage dysplasia ,renal tubular acidosis ,Turner syndrome ,premature infant ,intrauterine growth retardation ,etc .11 ca‐ses were the early maturing types of skeletal age ,108 cases were the normal skeletal age and 228 cases were the lately maturing type .The differences between the skeletal age and living age among all the cases this group were statistical‐ly significant（t= - 17 .157 ,P = 0 .000） .The skeletal age backward in idiopathic short stature（ P = 0 .000） ,growth hormone deficiency （ P = 0 .000 ） ,constitutional delay of growth and puberty （ P = 0 .000 ） ,hypothyroidism （ P=0 .000） ,cartilage dysplasia（P= 0 .002） and Turner syndrome（P = 0 .003） had statistical significance ,while the ad‐vanced skeletal age in precocious puberty（P= 0 .022） had statistical significance .Conclusion The main etiologies of children with short stature in Chongqing Wanzhou area are mainly idiopathic short stature ,growth hormone deficien‐cy ,constitutional delay of growth and puberty ,familial short stature and precocious puberty .The skeletal age of chil‐dren with short stature is overall lag .The skeletal age backward in idiopathic short stature ,grow th hormone deficien‐cy ,constitutional delay of grow th and puberty ,hypothyroidism ,cartilage dysplasia and Turner syndrome have statisti‐cal significance ,while the advanced skeletal age in precocious puberty has statistical significance .