286例儿童矮小症的病因分析  

Etiological analysis of 286 children with nanosomia.

作　　者：彭丽君 肖小兵[1] 黄冬梅 邓建荣[1] PENG Li-jun;XIAO Xiao-bing;HUANG Dong-mei;DENG Jian-rong(Department of Pediatrics,North Guangdong People's Hospital,Shaoguan 512026,Guangdong,CHINA)

机构地区：[1]粤北人民医院儿科,广东韶关512026

出　　处：《海南医学》2024年第23期3396-3399,共4页Hainan Medical Journal

基　　金：广东省韶关市卫生健康科研项目(编号:Y22047)。

摘　　要：目的探究儿童矮小症的病因,为该类患儿的诊断及治疗提供参考。方法回顾性分析2022年6月至2024年6月粤北人民医院收治的286例矮小症患儿的临床资料。所有患儿均符合《矮身材儿童诊治指南》中的诊断标准,通过病史采集、体格检查及辅助检查,记录相关数据,分析儿童矮小症的病因、不同病因矮小症患儿的临床特征及实验室指标,采用多因素Logistic逐步多元回归分析矮小症的影响因素。结果286例儿童矮小症的发病原因主要有10种,其中生长激素缺乏、特发性矮身材是发病的主要原因,分别占50.00%、25.17%,且生长激素缺乏症以男童居多;其次是先天性卵巢发育不全综合征,占10.84%,甲状腺功能减退、遗传性疾病、体质性青春期延迟分别占比10.84%、10.49%、5.94%;生长激素缺乏症、特发性矮身材、先天性卵巢发育不全综合征、甲状腺功能减退、遗传性疾病矮小症患儿的年龄集中在学龄期,不同病因患儿的父亲身高、母亲身高比较差异均有统计学意义(P<0.05);特发性矮身材及甲状腺功能减退患儿的骨龄平均延迟较高,不同病因的患儿骨龄平均延迟情况比较差异有统计学意义(P<0.05);生长激素缺乏症患儿的25羟维生素D[25(OH)D]、生长激素峰值明显低于其他病因患儿,不同病因患儿的25(OH)D、生长激素峰值比较差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,父亲身高(OR=2.883)、平均体质量指数(OR=1.679)、25(OH)D(OR=1.446)、血清胰岛素样生长因子1(IGF-1)(OR=2.328)、胰岛素样生长因子结合蛋白3(IGFBP-3)(OR=1.818)、生长激素峰值水平(OR=3.177)较低均是儿童矮小症的独立性危险因素(P<0.05)。结论儿童矮小症的病因复杂,以生长激素缺乏症、特发性矮身材、先天性卵巢发育不全综合征及甲状腺功能减退、遗传性疾病五类原因最为多见,父亲身高、平均体质量指数、25(OH)D、IGF-1、IGFBP-3Objective To explore and analyze the etiology of nanosomia in children,and to provide valuable reference for the diagnosis and treatment of such children.Methods The clinical data of 286 children with nanostature treated in North Guangdong People's Hospital from June 2022 to June 2024 were retrospectively analyzed.All the chil-dren met the diagnostic criteria in the Guidelines for Diagnosis and Treatment of Children with Short Stature.Through disease history collection,physical examination,and auxiliary examination,relevant data were recorded,and the etiolo-gy of childhood nanosomia,clinical characteristics,and laboratory indicators of children with different causes of nanoso-mia were analyzed.The influencing factors of nanosomia were analyzed by multivariate logistic step-by-step multiple re-gression.Results There were 10 main causes for nanosomia in the 286 children,and the top six were growth hormone deficiency(50.00%,mostly found in boys),idiopathic short stature(25.17%),congenital ovarian hypoplasia syndrome(10.84%),hypothyroidism(10.84%),hereditary diseases(10.49%),and physical delayed puberty(5.94%).The children with growth hormone deficiency,idiopathic short stature,congenital ovarian hypoplasia syndrome,hypothyroidism,and hereditary diseases was concentrated in school age.There were statistically significant differences in their fathers'height and mothers'height between children with different etiologies(P<0.05).The mean delay of bone age was higher in chil-dren with idiopathic short stature and hypothyroidism,and the difference in the mean delay of bone age between children with different causes was statistically significant(P<0.05).The peak values of 25(OH)D and growth hormone in children with growth hormone deficiency were significantly lower than those in children with other causes,and there were statisti-cally significant differences in the peak values of 25(OH)D and growth hormone between children with different causes(P<0.05).The results of multivariate logistic regression analysis showed that fat

关 键 词：儿童 矮小症 生长激素 卵巢 甲状腺功能 病因 影响因素 

分 类 号：R729[医药卫生—儿科]