Byard Pamela J
Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Childrens Hospital, Cleveland, Ohio 44106.
Am J Hum Biol. 1989;1(6):719-725. doi: 10.1002/ajhb.1310010609.
Mixed longitudinal height data from 1,170 cystic fibrosis patients seen at Rainbow Babies and Childrens Hospital in Cleveland form the basis for this analysis. As a group, the patients experience growth retardation throughout the growth cycle, with median height values below the 25th percentile of NCHS standards until late adolescence. Median height increments are also below normal standards until age 16 years in boys and 14 years in girls. Based on these results, it appears that some CF patients have very delayed adolescent growth spurts, and continue to grow into early adulthood. Pancreataic-enzyme-sufficient patients have greater height-for-age percentiles than enzyme-deficient patients after 9 years of age. The overall difference between enzyme-sufficient and enzyme-deficient patients is not statistically significant (P=0.058), perhaps because of small sample size for the enzyme-sufficient group (n=19). The correlation between pulmonary status assessed from lung X-rays and height increment peaks at age 10 years in girls and age 15 years in boys, with significant negative correlation occurring after age 16 years in both sexes. Although both pancreatic enzyme deficiency and lung disease appear to have some effect on linear growth in CF, especially during adolescence, these two factors explain a relatively small portion of the variation in growth percentiles.
来自克利夫兰彩虹婴儿与儿童医院的1170例囊性纤维化患者的混合纵向身高数据构成了本分析的基础。总体而言,这些患者在整个生长周期中都存在生长迟缓,直到青春期后期,其身高中位数均低于美国国家卫生统计中心(NCHS)标准的第25百分位数。男孩在16岁、女孩在14岁之前,身高的中位数增长也低于正常标准。基于这些结果,似乎一些囊性纤维化患者的青春期生长突增非常延迟,并持续生长至成年早期。9岁以后,胰腺酶充足的患者的年龄别身高百分位数高于酶缺乏的患者。胰腺酶充足和酶缺乏患者之间的总体差异无统计学意义(P = 0.058),这可能是因为胰腺酶充足组的样本量较小(n = 19)。根据肺部X光片评估的肺部状况与身高增长之间的相关性在女孩10岁、男孩15岁时达到峰值,16岁后两性均出现显著负相关。虽然胰腺酶缺乏和肺部疾病似乎都对囊性纤维化患者的线性生长有一定影响,尤其是在青春期,但这两个因素在生长百分位数的变异中所占比例相对较小。