Breukels M A, de Vroede M A M J
Universitair Medisch Centrum Utrecht, locatie Wilhelmina Kinderziekenhuis, afd. Kinderendocrinologie, Lundlaan 6, 3584 EA, Utrecht.
Ned Tijdschr Geneeskd. 2005 May 7;149(19):1021-4.
3 children presented with tall stature. A 14-year-old girl of 179.6 cm was found to be within her target height range and was treated with oestrogen. A 15.5-year-old boy of 199,5 cm was beyond his target height range and was found to have a 47,XYY karyo- type; growth was inhibited with epiphysiodesis. A 12-year-old girl of 178.5 cm and very long legs was beyond her target height range but was found to have homocysteinaemia, a contraindication for hormonal- growth inhibition. her final height was 192 cm. Children growing above the 98th percentile of the growth curve are considered too tall. Most children with tall stature are constitutionally tall and remain within their target height range; no additional investigation is needed. In contrast, growth above this range or disproportionate growth and/or the presence of dysmorphic features in the child or parents warrants further investigation and may reveal important diagnoses. Height prediction based on bone age reading plays a key role in the management of tall children. Treatment with sex steroids may be used in an attempt to limit final height, but some conditions underlying tall stature are a contraindication for this treatment.
3名儿童表现为身材高大。一名14岁、身高179.6厘米的女孩处于其目标身高范围内，接受了雌激素治疗。一名15.5岁、身高199.5厘米的男孩超出了其目标身高范围，被发现核型为47,XYY；通过骨骺固定术抑制生长。一名12岁、身高178.5厘米且腿非常长的女孩超出了其目标身高范围，但被发现患有高同型半胱氨酸血症，这是激素抑制生长的禁忌证，她的最终身高为192厘米。生长曲线高于第98百分位数的儿童被认为过高。大多数身材高大的儿童是体质性高大，仍在其目标身高范围内；无需进一步检查。相比之下，高于此范围的生长或不成比例的生长和/或儿童或父母存在畸形特征则需要进一步检查，可能会揭示重要诊断。基于骨龄读数的身高预测在高大儿童的管理中起着关键作用。使用性类固醇进行治疗可能试图限制最终身高，但身材高大的一些潜在病症是这种治疗的禁忌证。
