Sultan Mehboob, Afzal Muhammad, Qureshi Shaukat Mahmood, Aziz Shahid, Lutfullah Muhammad, Khan Shoaib Ali, Iqbal Mudassar, Maqsood Syed Uzair, Sadiq Nadeem, Farid Naeem
Department of Paediatrics, Combined Military Hospital, Multan, Pakistan.
J Coll Physicians Surg Pak. 2008 Aug;18(8):493-7.
To determine the causes of short stature in children with special emphasis on growth hormone deficiency.
Case series.
Department of Paediatrics, Military Hospital, Rawalpindi and Combined Military Hospital, Multan from September 2004 to January 2007.
Two hundred and fourteen children (140 boys and 74 girls), ranging from 02 to 15 years presenting with short stature were studied. Height and weight were plotted on appropriate growth charts and centiles determined. Relevant hematological and biochemical investigations including thyroid profile were done. Bone age was determined in all cases. Growth hormone axis was investigated after excluding other causes. Karyotyping was done in selected cases. Data was analyzed by SPSS 10.0 by descriptive statistics. Mean values were compared using t-test.
In this study, the five most common etiological factors in order of frequency were Constitutional Growth Delay (CGD), Familial Short Stature (FSS), malnutrition, coeliac disease and Growth Hormone Deficiency (GHD). In 37.4% of patients, the study revealed normal variants of growth - CGD, FSS or combination of both, 46.7% cases had nonendocrinological and 15.9% had endocrinological etiology. CGD (22.1%) in males and FSS (27%) in females were the most common etiology. GHD was found in 6.1% children and it comprised 38.2% of all endocrinological causes. Children with height falling below 0.4th centile were more likely to have a pathological short stature (79.2%) compared to 39.3% whose height was below 3rd centile but above 0.4th centile (p < 0.05).
CGD and FSS are most common causes of short stature in boys and girls respectively, whereas, GHD is a relatively uncommon etiology.
确定儿童身材矮小的原因，特别关注生长激素缺乏症。
病例系列研究。
2004年9月至2007年1月，拉瓦尔品第军事医院儿科及木尔坦联合军事医院。
对214名年龄在2至15岁、身材矮小的儿童（140名男孩和74名女孩）进行研究。将身高和体重绘制在适当的生长图表上并确定百分位数。进行包括甲状腺功能检查在内的相关血液学和生化检查。所有病例均测定骨龄。排除其他原因后对生长激素轴进行研究。对选定病例进行染色体核型分析。数据采用SPSS 10.0进行描述性统计分析。使用t检验比较均值。
在本研究中，按频率排序的五个最常见病因依次为体质性生长延迟（CGD）、家族性身材矮小（FSS）、营养不良、乳糜泻和生长激素缺乏症（GHD）。研究显示，37.4%的患者生长存在正常变异——CGD、FSS或两者兼有，46.7%的病例有非内分泌病因，15.9%有内分泌病因。男性中CGD（22.1%）和女性中FSS（27%）是最常见的病因。6.1%的儿童存在GHD，占所有内分泌病因的38.2%。身高低于第0.4百分位数的儿童比身高低于第3百分位数但高于第0.4百分位数的儿童更易患病理性身材矮小（79.2%对39.3%，p<0.05）。
CGD和FSS分别是男孩和女孩身材矮小最常见的原因，而GHD是相对少见的病因。
