Zaccaria M
Istituto di Semeiotica Medica, Università di Padova.
Minerva Endocrinol. 1990 Jan-Mar;15(1):73-8.
The term constitutional short stature is used to describe clinical situations characterized by low stature, assessed using special growth nomograms, but which are not due to specific endocrine alterations, nor to genetic causes or skeletal dysmorphisms, nor secondary to specific organ pathologies or chronic diseases. On the basis of this definition, our paper also includes the so-called normal variants of short stature (familial short stature and constitutional delay of growth) and intrauterine growth retardation. The endocrine and auxological features of constitutional short stature are described in the literature and provide an adequate basis for the use of therapies which include, in addition to growth hormone, substances capable of stimulating the endogenous secretion of the hormone (L-dopa, bromocriptine, clonidine, GHRH, pyridostigmine), or anabolic hormones. Biosynthetic growth hormone therapy is without doubt the most widely used, both on account of the extensive clinical experience and due to the easy availability of the drug made possible by the use of the biosynthetic molecule. Many subjects affected by constitutional short stature show a good response to hGH therapy, whereas others do not benefit by this treatment. New therapies using GHRH and neurodrugs, which are certainly easier to handle and less expensive, represent a new approach to the therapy of constitutional short stature but this condition still requires further investigation.
身材矮小,通过特殊生长曲线表评估,但并非由特定内分泌改变、遗传原因或骨骼畸形引起,也不是继发于特定器官病变或慢性疾病。基于这一定义,我们的论文还纳入了所谓身材矮小的正常变异情况(家族性矮小症和体质性生长延迟)以及宫内生长迟缓。体质性矮小症的内分泌和体格学特征在文献中有描述,为使用包括生长激素以及能够刺激该激素内源性分泌的物质(左旋多巴、溴隐亭、可乐定、生长激素释放激素、吡啶斯的明)或合成代谢激素在内的疗法提供了充分依据。生物合成生长激素疗法无疑是使用最广泛的,这既是因为广泛的临床经验,也是由于使用生物合成分子使得药物易于获取。许多患有体质性矮小症的患者对生长激素疗法反应良好,而其他患者则未从这种治疗中获益。使用生长激素释放激素和神经药物的新疗法肯定更易于操作且成本更低,代表了体质性矮小症治疗的一种新方法,但这种情况仍需要进一步研究。