Doyle L W, Ford G W, Abadilla B, Warne G L, Callanan C
Department of Obstetrics, Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
J Paediatr Child Health. 1993 Dec;29(6):411-4. doi: 10.1111/j.1440-1754.1993.tb03010.x.
The aims of this study of short very low birthweight (VLBW) children at or after 8 years of age were to determine: (i) if there were any unsuspected organic causes for their growth failure; and (ii) whether any children might be suitable for treatment with synthetic growth hormone. Thirty-seven of 195 (19%) VLBW children seen at 8 years had heights < 10th centile, and of these only 40% (10/25) of families offered an assessment were concerned enough to have the child fully evaluated. No child had an unsuspected organic cause of short stature. The children's parents were significantly shorter than expected for Caucasians (mean parental height s.d. score = -1.06 (s.d. 0.72), t = -5.9, P < 0.001). On average, the bone age of the short children was delayed by 14.9 months (s.d. 18.8 months) compared with chronological age (t = -3.4, P < 0.01). When compared with their parents, the children's mean height s.d. score for their bone age was not significantly different (mean height s.d. score for bone age = -0.83 (s.d. 1.3), t = 0.6, NS). Only three children qualified for treatment with synthetic growth hormone; all three had been small for gestational age at birth and had birthweights < 1000 g. In conclusion, in short VLBW children, only a minority of families and children are likely to be concerned enough about short stature to be fully assessed; an unsuspected organic cause for growth failure is unlikely, and only a few will qualify for synthetic growth hormone therapy.
本研究针对8岁及以上的超低出生体重（VLBW）儿童，旨在确定：（i）其生长发育迟缓是否存在任何未被察觉的器质性原因；以及（ii）是否有儿童适合接受合成生长激素治疗。在195名8岁时接受检查的VLBW儿童中，有37名（19%）身高低于第10百分位数，在这些儿童中，只有40%（10/25）的家庭同意进行评估，并且足够重视到让孩子接受全面评估。没有儿童存在未被察觉的身材矮小的器质性原因。这些儿童的父母明显比高加索人预期的要矮（父母平均身高标准差分数=-1.06（标准差0.72），t=-5.9，P<0.001）。与实际年龄相比，身材矮小儿童的骨龄平均延迟了14.9个月（标准差18.8个月）（t=-3.4，P<0.01）。与他们的父母相比，这些儿童骨龄对应的平均身高标准差分数没有显著差异（骨龄对应的平均身高标准差分数=-0.83（标准差1.3），t=0.6，无显著性差异）。只有三名儿童符合合成生长激素治疗的条件；这三名儿童均为小于胎龄儿，出生体重<1000g。总之，在身材矮小的VLBW儿童中，只有少数家庭和儿童可能会足够关注身材矮小问题而接受全面评估；生长发育迟缓不太可能存在未被察觉的器质性原因，只有少数儿童符合合成生长激素治疗的条件。
