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[关于改善软骨发育不全患儿身高结局的早期诊断与治疗的意义及考量]

[Significance and considerations of early diagnosis and treatment for improving height outcomes in children with achondroplasia].

作者信息

Li Li, Xiong Feng

机构信息

Department of Endocrinology, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing 400014, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2025 Mar 15;27(3):262-268. doi: 10.7499/j.issn.1008-8830.2410107.

DOI:10.7499/j.issn.1008-8830.2410107
PMID:40105070
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11928039/
Abstract

Achondroplasia (ACH) is a common skeletal dysplasia in children, primarily caused by mutations in the fibroblast growth factor receptor 3 () gene. These mutations disrupt the process of endochondral ossification in different types of bones, including long bones of the limbs and vertebrae. Children with ACH typically present with short stature and may experience severe multi-system complications. The diagnosis of ACH is based on typical clinical manifestations, imaging features, and genetic testing results. Treatment options mainly include pharmacological interventions and surgical procedures aimed at improving height, as well as symptomatic management for associated complications. This article discusses both prenatal and clinical diagnostic approaches for ACH, as well as treatment strategies focused on enhancing height, aiming to deepen the understanding of this condition.

摘要

软骨发育不全(ACH)是儿童常见的骨骼发育异常,主要由成纤维细胞生长因子受体3()基因突变引起。这些突变扰乱了不同类型骨骼的软骨内成骨过程,包括四肢长骨和椎骨。ACH患儿通常表现为身材矮小,并可能出现严重的多系统并发症。ACH的诊断基于典型的临床表现、影像学特征和基因检测结果。治疗选择主要包括旨在改善身高的药物干预和外科手术,以及对相关并发症的对症处理。本文讨论了ACH的产前和临床诊断方法,以及旨在增加身高的治疗策略,旨在加深对这种疾病的理解。

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本文引用的文献

1
Foetal achondroplasia: Prenatal diagnosis, outcome and perspectives.胎儿软骨发育不全:产前诊断、结局及展望。
J Gynecol Obstet Hum Reprod. 2025 Feb;54(2):102891. doi: 10.1016/j.jogoh.2024.102891. Epub 2024 Dec 5.
2
Consensus Guidelines for the Use of Vosoritide in Children with Achondroplasia in Australia.澳大利亚使用伏索瑞肽治疗软骨发育不全儿童的共识指南。
Children (Basel). 2024 Jun 28;11(7):789. doi: 10.3390/children11070789.
3
Review of published 467 achondroplasia patients: clinical and mutational spectrum.已发表的467例软骨发育不全患者的综述:临床和突变谱。
Orphanet J Rare Dis. 2024 Jan 27;19(1):29. doi: 10.1186/s13023-024-03031-1.
4
Vosoritide therapy in children with achondroplasia aged 3-59 months: a multinational, randomised, double-blind, placebo-controlled, phase 2 trial.在 3-59 个月大的软骨发育不全儿童中进行 Vosoritide 治疗:一项多中心、随机、双盲、安慰剂对照的 2 期试验。
Lancet Child Adolesc Health. 2024 Jan;8(1):40-50. doi: 10.1016/S2352-4642(23)00265-1. Epub 2023 Nov 18.
5
Once-weekly TransCon CNP (navepegritide) in children with achondroplasia (ACcomplisH): a phase 2, multicentre, randomised, double-blind, placebo-controlled, dose-escalation trial.每周一次的跨环辛肽(那韦肽)用于软骨发育不全儿童(ACcomplisH):一项2期、多中心、随机、双盲、安慰剂对照、剂量递增试验。
EClinicalMedicine. 2023 Oct 2;65:102258. doi: 10.1016/j.eclinm.2023.102258. eCollection 2023 Nov.
6
How pain affect real life of children and adults with achondroplasia: A systematic review.成骨不全症患儿及成人的疼痛对现实生活的影响:系统评价。
Eur J Med Genet. 2023 Nov;66(11):104850. doi: 10.1016/j.ejmg.2023.104850. Epub 2023 Sep 26.
7
The clinical management of children with achondroplasia in Italy: results of clinician and parent/caregiver surveys.意大利软骨发育不全患儿的临床管理:临床医生及家长/照料者调查结果
J Endocrinol Invest. 2024 Feb;47(2):345-356. doi: 10.1007/s40618-023-02151-y. Epub 2023 Jul 19.
8
Achondroplasia: Update on diagnosis, follow-up and treatment.软骨发育不全:诊断、随访及治疗的最新进展
An Pediatr (Engl Ed). 2022 Dec;97(6):423.e1-423.e11. doi: 10.1016/j.anpede.2022.10.004. Epub 2022 Nov 5.
9
Does the technique of limb lengthening affect physeal growth in patient with achondroplasia? Comparison of the simultaneous and consecutive tibia and femur lengthening with external fixators.肢体延长技术是否会影响软骨发育不全患者的骺板生长?外固定架同期和连续延长胫骨和股骨的比较。
J Pediatr Orthop B. 2023 Jan 1;32(1):60-65. doi: 10.1097/BPB.0000000000001011.
10
Optimising the diagnosis and referral of achondroplasia in Europe: European Achondroplasia Forum best practice recommendations.优化欧洲软骨发育不全的诊断和转诊:欧洲软骨发育不全论坛最佳实践建议。
Orphanet J Rare Dis. 2022 Jul 27;17(1):293. doi: 10.1186/s13023-022-02442-2.