生长缓慢儿童156例病因分析(1)
[摘要]目的 探讨生长缓慢患儿的病因构成，为临床诊断治疗提供参考依据。方法 回顾性分析2011年6月～2016年6月就诊的156例生长缓慢患儿的临床资料，分析其病因。结果 156例生长缓慢患儿中，平均年龄(7.43±2.37)岁，其中男童95例(61%)，女童61例(39%)；原发性生长激素缺乏症68例(43.6%)，特发性矮小(疑似)45例(28.8%)，小于胎龄儿4例(2.6%)，染色体疾病6例(3.8%)(其中Turner综合征4例，其它染色体异常2例)，颅内肿瘤10例(6.4%)(其中包括颅咽管瘤术后继发多种垂体激素缺乏症1例，生殖细胞瘤放疗术后继发多种垂体激素缺乏症1例，垂体微腺瘤8例)，垂体柄中断1例(0.6%)，肝功能损害10例(6.4%)，慢性胃炎4例(2.6%)，先天性心脏病3例(1.9%)，慢性肾功能衰竭1例(0.6%)，Bartte综合征1例(0.6%)，有机酸血症2例(1.3%)，心理情感障碍1例(0.6%)。结论 生长激素缺乏症是儿童生长缓慢的最常见病因，但儿童生长缓慢病因复杂，需根据不同病因选择治疗方案。
[关键词]生长缓慢；矮身材；儿童；病因学
[中图分类号] R725.8 [文献标识码] A [文章编号] 1674-4721(2016)10(c)-0078-04
[Abstract]Objective To explore the etiology in the children patients with poor growth，and to provide reference for clinical diagnosis and treatment.Methods Clinical data of 156 children patients with poor growth from June 2011 to June 2016 were retrospectively analyzed，the cause of the disease was analyzed.Results Among the 156 children patients with poor growth，the average age was (7.43±2.37) years，including 95 boys (61%) and 61 girls (39%).Primary growth hormone deficiency were seen in 68 cases (43.6%)，idiopathic pygmyism (suspected) were seen in 45 cases (28.8%)，smaller gestational age were seen in 4 cases (2.6%)，chromosomal disease were seen in 6 cases (3.8%) (Turner syndrome in 4 cases，other chromosomal abnormalities in 2 cases)，intracranial tumors were seen in 10 patients(6.4%) (including postoperative craniopharyngioma secondary to a variety of pituitary hormone deficiency in 1 case，postoperative germ cell tumors secondary to a variety of pituitary hormone deficiency in 1 case，pituitary microadenoma in 8 cases)，pituitary stalk breakage was seen in 1 case (0.6%)，liver function damage were seen in 10 cases (6.4%)，and chronic gastritis were seen in 4 cases (2.6%)，congenital heart disease were seen in 3 cases (1.9%)，chronic renal failure was seen in 1 case (0.6%)，Bartte syndrome was seen in 1 case (0.6%)，organic acidemia were seen in 2 cases (1.3%)，and psychological affective disorder was seen in 1 case (0.6%).Conclusion Growth hormone deficiency is the most common cause of poor growth in children，however，the etiology of slow growth in children is complicated，and an appropriate treatment protocol should be selected based on different causes of disease.
[Key words]Poor growth；Short stature；Children；Etiology
矮身材是儿科内分泌的常见疾病。目前，我国矮身材的定义为在相似生活环境下，同种族、同性别和年龄的个体身高低于正常人群平均身高2个标准差者(-2 SD)，或低于第3百分位数(-1.88 SD)者[1]。在临床实践中，有相当数量的儿童以生长缓慢为主诉就诊，通过监测身高增长速率半年以上，证实其存在生长缓慢，身高百分位有下降趋势，但始终在第3百分位(P3)到第10百分位(P10)。分析导致儿童生长缓慢的病因构成比，对预防矮身材的发生具有一定意义；根据生长缓慢儿童的不同病因选择恰当的干预方法，对改善儿童的最终成年身高具有重要意义，但国内少见此类研究报道。为此，我院儿科对此类患儿进行了相关检查与诊治，现整理临床资料完整的生长缓慢儿童病例，针对其病因构成进行分析，报道如下。 (洪庆荣 顾绍庆 徐丽琴 叶元枫)
[关键词]生长缓慢；矮身材；儿童；病因学
[中图分类号] R725.8 [文献标识码] A [文章编号] 1674-4721(2016)10(c)-0078-04
[Abstract]Objective To explore the etiology in the children patients with poor growth，and to provide reference for clinical diagnosis and treatment.Methods Clinical data of 156 children patients with poor growth from June 2011 to June 2016 were retrospectively analyzed，the cause of the disease was analyzed.Results Among the 156 children patients with poor growth，the average age was (7.43±2.37) years，including 95 boys (61%) and 61 girls (39%).Primary growth hormone deficiency were seen in 68 cases (43.6%)，idiopathic pygmyism (suspected) were seen in 45 cases (28.8%)，smaller gestational age were seen in 4 cases (2.6%)，chromosomal disease were seen in 6 cases (3.8%) (Turner syndrome in 4 cases，other chromosomal abnormalities in 2 cases)，intracranial tumors were seen in 10 patients(6.4%) (including postoperative craniopharyngioma secondary to a variety of pituitary hormone deficiency in 1 case，postoperative germ cell tumors secondary to a variety of pituitary hormone deficiency in 1 case，pituitary microadenoma in 8 cases)，pituitary stalk breakage was seen in 1 case (0.6%)，liver function damage were seen in 10 cases (6.4%)，and chronic gastritis were seen in 4 cases (2.6%)，congenital heart disease were seen in 3 cases (1.9%)，chronic renal failure was seen in 1 case (0.6%)，Bartte syndrome was seen in 1 case (0.6%)，organic acidemia were seen in 2 cases (1.3%)，and psychological affective disorder was seen in 1 case (0.6%).Conclusion Growth hormone deficiency is the most common cause of poor growth in children，however，the etiology of slow growth in children is complicated，and an appropriate treatment protocol should be selected based on different causes of disease.
[Key words]Poor growth；Short stature；Children；Etiology
矮身材是儿科内分泌的常见疾病。目前，我国矮身材的定义为在相似生活环境下，同种族、同性别和年龄的个体身高低于正常人群平均身高2个标准差者(-2 SD)，或低于第3百分位数(-1.88 SD)者[1]。在临床实践中，有相当数量的儿童以生长缓慢为主诉就诊，通过监测身高增长速率半年以上，证实其存在生长缓慢，身高百分位有下降趋势，但始终在第3百分位(P3)到第10百分位(P10)。分析导致儿童生长缓慢的病因构成比，对预防矮身材的发生具有一定意义；根据生长缓慢儿童的不同病因选择恰当的干预方法，对改善儿童的最终成年身高具有重要意义，但国内少见此类研究报道。为此，我院儿科对此类患儿进行了相关检查与诊治，现整理临床资料完整的生长缓慢儿童病例，针对其病因构成进行分析，报道如下。 (洪庆荣 顾绍庆 徐丽琴 叶元枫)