Naiki Yasuhiro, Horikawa Reiko, Tanaka Toshiaki
Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan.
Clin Pediatr Endocrinol. 2013 Apr;22(2):25-32. doi: 10.1292/cpe.22.25. Epub 2013 Apr 26.
To evaluate the psychosocial status of short children with and without growth hormone therapy (GHT) and that of their parents, self-administered questionnaires were collected from patients and parents who regularly visit the outpatient clinics participating in the Child Health and Development Network. Completed questionnaires were received for one hundred and thirteen patients with GHT and 67 patients without GHT. According to the parents, both children with GHT and without GHT have no difficulty in their daily lives (89% vs. 95%) and are positive (56% vs. 65%), respectively. Ninety-eight percent of parents of children with GHT and 83% of parents of children without GHT had expected the current treatment strategy to be effective. Parents of children with GHT are more satisfied with the current therapy than those without GHT (79% vs. 50%), and feel less anxiety about the on-going therapy than (31% vs. 58%, respectively). Children treated with or without equally reported having no difficulty in their daily lives (90% vs. 93%), and being positive in their lives (81% vs. 75%, respectively) despite their short stature. Although less than one third of the patients have been bullied in their classroom (26% with GHT vs. 29% without GHT), younger and shorter children tend to be bullied more often. Short children undergoing GHT and their parents have anxiety regarding their height and expectations of the effect of GHT. It is important for doctors to inform their patients regarding realistic height expectations before starting GHT. Additionally, medical consultation is recommended for patients who remain below -2 SD in height despite GHT.
为评估接受和未接受生长激素治疗（GHT）的矮小儿童及其父母的心理社会状况，我们从定期前往参与儿童健康与发展网络的门诊就诊的患者及其父母处收集了自填式问卷。共收到113例接受GHT治疗的患者和67例未接受GHT治疗的患者填写完整的问卷。据父母反馈，接受GHT治疗和未接受GHT治疗的儿童在日常生活中均无困难（分别为89%和95%），且态度积极（分别为56%和65%）。接受GHT治疗儿童的父母中有98%，未接受GHT治疗儿童的父母中有83%认为当前的治疗策略会有效。接受GHT治疗儿童的父母对当前治疗的满意度高于未接受GHT治疗儿童的父母（分别为79%和50%），且对正在进行的治疗感到焦虑的程度更低（分别为31%和58%）。接受或未接受治疗的儿童均表示尽管身材矮小，但在日常生活中没有困难（分别为90%和93%），且生活态度积极（分别为81%和75%）。虽然不到三分之一的患者在课堂上受到过欺负（接受GHT治疗的为26%，未接受GHT治疗的为29%），但年龄较小和身材较矮的儿童更容易受到欺负。接受GHT治疗的矮小儿童及其父母对身高以及GHT治疗效果的期望存在焦虑。医生在开始GHT治疗前告知患者关于实际身高期望非常重要。此外，对于尽管接受了GHT治疗但身高仍低于-2标准差的患者，建议进行医学咨询。
