Thomsett Michael J
Department of Endocrinology, Mater Children's Hospital, Queensland, Australia.
J Paediatr Child Health. 2009 Jan-Feb;45(1-2):58-63. doi: 10.1111/j.1440-1754.2008.01428.x.
Extreme tall stature may lead to a variety of concerns in tall children and their parents, leading to requests for treatment to reduce final height in some children. This study reviews referrals for tall stature to a single pediatric endocrinologist and results of treatment over 25 years from 1980 to 2004.
Diagnoses, heights, target heights and estimated final heights at presentation, and final heights and complications in treated patients, were examined by retrospective chart review.
Of 345 referrals, 244 (71%) were girls and 101 (29%) were boys. Of the 68 (19.7%) treated, 53 (78%) were girls and 15 (22%) were boys. Most children had familial tall stature. Treated children were tall for their already tall families. Treatment reduced final heights compared with estimated final heights by (mean +/- standard error of the mean) 4.2 +/- 0.5 cm (P = 0.001) in girls and 5.1 +/- 0.8 cm (P < 0.001) in boys. Minor complications occurred in 27 (51%) girls, including 5 (9.4%) who stopped treatment because of weight gain, and 5 (33%) of boys. In more recent years, girls (but not boys) presented less frequently, were taller at presentation and opted for treatment less often, and at taller estimated final heights than in the earlier years.
Any benefits of high-dose sex steroid treatment of tall children in terms of reduced final height and improved self-image are at the expense of complications in many. Fewer tall girls being referred and treated probably reflects altered attitudes to tallness in society. Such treatment should seldom - if ever - be used in the future.
身材极高可能会给身材高大的儿童及其父母带来各种困扰，导致一些儿童要求进行治疗以降低最终身高。本研究回顾了1980年至2004年25年间转诊至一位儿科内分泌专家处的身材高大患者以及治疗结果。
通过回顾性病历审查，检查诊断结果、就诊时的身高、目标身高和估计最终身高，以及接受治疗患者的最终身高和并发症情况。
在345例转诊患者中，244例（71%）为女孩，101例（29%）为男孩。在接受治疗的68例（19.7%）患者中，53例（78%）为女孩，15例（22%）为男孩。大多数儿童为家族性身材高大。与估计最终身高相比，治疗使女孩的最终身高降低了（平均±平均标准误差）4.2±0.5厘米（P = 0.001），男孩降低了5.1±0.8厘米（P < 0.001）。27例（51%）女孩出现轻微并发症，其中5例（9.4%）因体重增加而停止治疗，男孩中有5例（33%）出现并发症。近年来，女孩（而非男孩）就诊频率降低，就诊时身高更高，选择治疗的频率更低，且估计最终身高比早年更高。
高剂量性类固醇治疗身材高大儿童在降低最终身高和改善自我形象方面的任何益处，都以许多并发症为代价。转诊并接受治疗的身材高大女孩减少，可能反映了社会对身材高大态度的转变。未来应极少（如果有的话）使用这种治疗方法。
