儿童矮小症病因及临床诊治研究分析

Analysis of the Etiology and Clinical Diagnosis and Treatment of Childhood Dwarfism

目的儿童矮小症病因及临床诊治研究分析。方法纳入我院2016年2月1日至2022年9月1日收治的110例矮小症儿童的临床资料进行回顾性分析。结果入组矮小症儿童男性55.45%,女性44.55%,平均年龄(7.91±2.69)岁。完全性生长激素缺乏症(GHD)40.00%,部分性GHD43.64%,特发性身材矮小(ISS)和家族性矮小症(FSS)13.64%,体质性生长和青春期延迟0.91%,Turner综合征1.82%。GHD组和ISS+FSS组对比年龄均值、性别构成、BMI均值无明显差异(P>0.05)。GHD组和ISS+FSS组对比骨龄落后(实际年龄-骨龄)平均值更大(P<0.05)。BMI与骨龄落后值相关系数为-0.356(P<0.01)。激发试验峰值出现时间空腹(1.8%)、30 min(10.0%)、60 min(49.1%)、90 min(29.1%)、120 min(10.0%)。结论GHD是矮小症的主要病因。GHD常见骨龄落后,但骨龄正常或者超前也可能存在GHD。BMI与骨龄有相关性,BMI越大可能存在骨龄正常或超前。胰岛素和可乐定激发试验生长激素峰值出现时间不定,多出现在30、90 min。早期识别、诊断矮小症病因,尽早干预有重要意义。

Objective Etiology and clinical diagnosis and treatment of childhood dwarfism.Methods The clinical data of 110 children with short stature admitted to our hospital from February 12016 to September 12022 were retrospectively analyzed.Results There were 55.45%males and 44.55%females with an average age of(7.91±2.69)years.40.00%complete growth hormone deficiency(GHD),43.64%partial GHD,idiopathic short stature(ISS)and familial short stature(13.64%),constitutional growth and delayed puberty(0.91%),turner syndrome(1.82%).There was no significant difference in age,gender composition and BMI between GHD group and ISS+FSS group(P>0.05).Compared with the ISS+FSS group,the GHD group had a greater mean bone age lag(chronological age-bone age)(P<0.05).The correlation coefficient between BMI and delayed bone age was-0.356(P<0.01).The peak time of GH stimulation test was empty stomach(1.8%),30 minutes(10.0%),60 minutes(49.1%),90 minutes(29.1%)and 120 minutes(10.0%).Conclusions GHD is the main cause of short stature.Delayed bone age is common in GHD,but normal or advanced bone age may also exist in GHD.There is a correlation between BMI and delayed bone age.GDH children with higher BMI may have normal or advanced bone age.The peak of GH in insulin and clonidine challenge tests appeared at 30 and 90 minutes.Early identification and diagnosis of the causes of short stature and early intervention are of great significance.