136例住院矮身材儿童不同干预方法的临床观察-现代医学

136例住院矮身材儿童不同干预方法的临床观察

作者：汤涌泉¹ 王婕¹ 许媛媛¹ 朱艳丽² 汤爱梅² 谷奇² 谭娟² 李月娥² 高钱² 杨明明² 王映丹² 周文娣¹

单位：1. 南京医科大学附属淮安第一医院儿科, 江苏淮安 223300;
2. 徐州医科大学淮安临床学院儿科, 江苏淮安 223300

分类号：R725.8

出版年·卷·期（页码）：2023·51·第八期（1073-1077）

摘要：

目的：探讨不同干预方法对地处苏北的淮安地区矮身材儿童的影响，为本地区儿童矮身材的防治提供科学依据。方法：回顾性分析南京医科大学附属淮安第一医院2020年12月至2021年12月收治的136例矮身材患儿的临床资料，通过统计学分析了解本地区矮身材患儿常见病因、诊疗情况及重组人生长激素治疗(rhGH)和生活方式干预的疗效差异等。结果：就诊的136例矮身材患儿，男女比例为1.72∶1，病因包括生长激素缺乏(GHD)(69.85%)、特发性矮身材(ISS)(24.26%)、小于胎龄(SGA)(5.15%)及甲状腺功能减退(0.74%)。48例患儿接受rhGH治疗；另87例患儿因家长原因未接受rhGH治疗，给予生活方式干预；1例甲状腺功能减退患儿接受甲状腺激素替代治疗。随访6个月后rhGH治疗组和生活方式干预组患儿身高、身高标准差积分(HtSDS)均明显改善(P<0.05)，但rhGH治疗组患儿较生活方式干预组患儿HtSDS差异更大；与正常对照组相比，两组随访6个月后生长速率均明显增加。结论：本地区矮身材儿童就诊人群以男孩居多；病因以GHD及ISS为主；rhGH治疗患儿占比较低；rhGH与生活方式干预均可明显改善患儿身高，但rhGH较生活方式干预改善身高效果更显著。

Objective: To investigate the effects of different intervention methods on short stature children in Huai'an area and to provide scientific basis for the prevention and treatment of short stature children in this region. Methods: From December 2020 to December 2021, the clinical data of 136 children with short stature admitted to the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University were retrospectively analyzed. Statistical analysis was conducted to understand the common etiology, diagnosis, and treatment of children with short stature in this region, as well as the difference in efficacy between recombinant human growth hormone therapy(rhGH) and lifestyle intervention. Results:Among the 136 children with short stature, the male to female ratio was 1.72∶1. The causes included growth hormone deficiency(GHD)(69.85%), idiopathic short stature(ISS)(24.26%), small for gestational age(SGA)(5.15%) and hypothyroidism(0.74%). Forty-eight children received rhGH treatment, while the remaining 87 children did not receive rhGH treatment due to parental reasons and instead underwent lifestyle intervention. One child with hypothyroidism received thyroid hormone replacement therapy.After 6 months, the height and HtSDS of children in the rhGH treatment group and the lifestyle intervention group showed significant improvement(P<0.05). However, the HtSDS of children treated with rhGH was significantly better than those in the lifestyle intervention group. Both groups showed a significant increase in growth rate compared to the normal control group after 6 months. Conclusion: Short stature children in this area are predominantly boys, with GHD and ISS being the primary causes. The utilization of rhGH treatment for these children is relatively low. Both rhGH and lifestyle intervention have shown significant improvement in children's height, but rhGH has proven to be more effective than lifestyle intervention.

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