临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (1): 39-42.doi: 10.3969/j.issn.1000-3606.2019.01.010

• 综合报道 • 上一篇    下一篇

矮小症病因及临床特征分析

韩晓伟,董治亚,张婉玉,等   

  1. 上海交通大学医学院附属瑞金医院儿内科(上海 200025)
  • 出版日期:2019-01-15 发布日期:2019-02-01
  • 基金资助:
    董治亚 电子信箱:dzy831@126.com

Analysis of the etiology and clinical characteristics of short stature

HAN Xiaowei, DONG Zhiya, ZHANG Wanyu, et al   

  1. Department of Endocrinology of Pediatrics, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2019-01-15 Published:2019-02-01

摘要: 目的 探讨矮小症的病因及临床特点。方法 回顾分析1995年5月到2017年7月治疗的2 075例矮小症患儿的 临床资料,分析病理性矮小和正常变异性矮小的病因及分布频率,分析生长激素缺乏症(GHD)、特发性矮小(ISS)、体质性生 长延迟(CDG)和家族性矮小(FSS)的临床特征差异,分析严重矮小(身高SDS≤-3)及一般性矮小(身高SDS>-3)的病因 差异。结果 在2 075例诊断为矮小症的患儿中,1 719例(82.84%)为病理性矮小,其中GHD(38.60%)和ISS(22.02%) 较为多见。356例(17.16%)为正常变异性矮小,FSS、CDG分别占10.70%和6.46%。 4种常见儿童矮小症(GHD、ISS、 CDG和FSS)的性别比、初诊年龄、身高标准差比值(SDS)、体质指数(BMI)、骨龄、骨龄延迟的差异均有统计学意义 (P<0.01)。4种儿童矮小症均男性多于女性。GHD组身高SDS最低,CDG组最高;GHD组BMI最高,而CDG和ISS组则较低; GHD组骨龄延迟最多,而CDG组最少。严重矮小组中,完全性生长激素缺乏症、多垂体激素缺乏症、小于胎龄儿、特纳综 合征、甲状腺功能减退症、Russell-Silver综合征的比例高于一般性矮小组;而部分性生长激素缺乏症、ISS、FSS、CDG的比 例低于一般性矮小组。结论 矮小症病因复杂,分析病因及临床特征有助于临床诊断和治疗。

关键词: 病理性矮小; 正常变异性矮小; 矮小症

Abstract: Abstract: Objective To explore the etiology and clinical characteristics of short stature. Method Clinical data of 2075 children with short stature treated from May 1995 to July 2017 were retrospectively analyzed. The etiology and morbidity of pathological short stature and normal variant short stature were analyzed. The clinical characteristics of growth hormone deficiency (GHD), idiopathic short stature (ISS), constitutional delay in growth (CDG) and familial short stature (FSS) were analyzed. The etiological differences between severe short stature [height standard deviation score (SDS) ≤-3] and general short stature (height SDS >-3) were analyzed. Results Among 2075 children diagnosed with short stature, 1719 (82.84%) were pathological short stature, among which GHD (38.60%) and ISS (22.02%) were more common. Normal variant short stature was found in 356 children (17.16%), with FSS and CDG accounting for 10.70% and 6.46% respectively. There were statistically significant differences in the sex ratio, age at initial diagnosis, height SDS, body mass index (BMI), bone age and bone age delay among children with four common childhood short stature (GHD, ISS, CDG and FSS) (all P<0.01). Boys were more than girls in four kinds of childhood short stature. The height SDS was the lowest in GHD group and the highest in CDG group; BMI was highest in GHD group, but lower in CDG and ISS group. Bone age delay was highest in GHD group and lowest in CDG group. In severe short stature group, the rates of complete GHD, multiple pituitary hormone deficiency, small for gestational age infant, Turner syndrome, hypothyroidism and Russell-Silver syndrome were higher than those in general short stature group, but the rates of partial GHD, ISS, FSS and CDG was lower than those in general short stature group. Conclusion The etiology of short stature is complex. Analysis of the etiology and clinical features is helpful for clinical diagnosis and treatment.

Key words:  pathological short stature; normal variant short stature; short stature