http://jcp.xinhuamed.com.cn:8080/CN/1000-3606/home.shtml 2 132 例矮小症患儿病因及骨龄分析

临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (8): 730-.doi: 10.3969 j.issn.1000-3606.2015.08.012

• 综合报道 • 上一篇    下一篇

2 132 例矮小症患儿病因及骨龄分析

武苏1,汪素美2,朱子阳1,顾威1,倪世宁1,石星1,刘倩琦1   

  1. 1. 南京医科大学附属南京儿童医院内分泌科( 江苏南京 210000);2. 南京医科大学第四临床医学院( 江苏南京 210000)
  • 收稿日期:2015-08-15 出版日期:2015-08-15 发布日期:2015-08-15
  • 通讯作者: 刘倩琦 E-mail:18951769617@163.com

Etiology and bone age of 2132 children with short stature

WU Su1, WANG Sumei2, ZHU Ziyang1, GU Wei1, NI Shining1,SHI Xing1, LIU Qianqi1   

  1. 1. Department of Endocrinology, Nanjing Children's Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu China; 2. Nanjing Medical University, Nanjing 210000, Jiangsu, China
  • Received:2015-08-15 Online:2015-08-15 Published:2015-08-15

摘要: 目的 探讨矮小症患儿的病因分类及其骨龄落后情况。方法 回顾性分析2009年1月至2014年12月住院治疗2 132例矮小症患儿的临床资料。结果 2 132例矮小症患儿中男1 333例、女799例,平均年龄(9.03±3.04)岁,平均骨龄(6.81±3.05岁);完全性生长激素缺乏症324例(15.20%),部分性生长激素缺乏症 780例(36.58%),多垂体激素缺乏症27例(1.27%),甲状腺功能减低症13例(0.61%),特发性矮小893例(41.89%),低出生体质量儿19例(0.89%);骨骼发育障碍8例(0.38%),颅内肿瘤13例(0.61%),慢性系统性疾病15例(0.70%),染色体疾病40例(1.88%)。ANOVA分析显示,不同病因组骨龄落后情况不同,多垂体激素缺乏症、颅内肿瘤导致的矮小症骨龄落后较其余各病因组明显。生长激素峰值与骨龄落后值之间存在负相关关系。结论 生长激素缺乏症是矮小症最常见病因。矮小症患儿普遍存在骨龄落后,骨龄落后值与生长激素峰值之间存在负相关关系,联合激素缺乏对骨龄的影响更为显著。

Abstract:  Objective The aim of this study is to analyze the etiology and status of bone age of children with short stature. Methods Anthropological and physical examination data were retrospectively collected and studied in 2132 children with short stature in the department of endocrinology between 2009 and 2014. Growth hormone (GH) levels were determined by arginine-clonidine test. Bone age was determined by CHN scoring. Results Among the 2132 patients, 1333 were males and 799 were females. Mean age is 9.03 ± 3.04 years old, mean bone age is 6.81 ± 3.05 years. Of them, 324 cases (15.2%) were diagnosed complete GH deficiency, 780 cases (36.59%) were partial GH deficiency, 27cases (1.27%) were multiple pituitary hormone deficiency, 13 cases (1.64%) were hypothyroidism, 893 cases (41.89%) were idiopathic short stature, 19 cases (0.89%) were small for gestational age (SGA), 40 cases (1.88%) were chromosomal disorders, etc. Significant difference in age and bone age was  found using t test (P< 0.05). Significant differences in Δage were found between etiological categories using ANOVA (P=0.000). Δage was significantly and negatively associated with peak GH using Pearson's correlation. Conclusions GH deficiency is the most common cause of short stature. Bone age of children with short stature is commonly delayed. Δage was significantly and negatively associated with peak GH. Multiple pituitary hormone deficiency has a significant effect on bone age. The etiology of patients with short stature cannot be determined just by bone age.