Stabler B, Siegel P T, Clopper R R, Stoppani C E, Compton P G, Underwood L E
University of North Carolina at Chapel Hill, 27599-7160, USA.
J Pediatr. 1998 Sep;133(3):366-73. doi: 10.1016/s0022-3476(98)70271-9.
To measure the prevalence of behavioral and learning problems among children with short stature and to assess the effect of growth hormone (GH) treatment on such problems.
A total of 195 children with short stature (age range 5 to 16 years, mean age 11.2 years) were tested for intelligence, academic achievement, social competence, and behavior problems before beginning GH therapy and yearly during 3 years of treatment. Children were classified as having growth hormone deficiency (GHD) when GH responses to provocative stimuli were <10 ng/mL (n = 109) and as having idiopathic short stature (ISS) when >10 ng/mL (n = 86). A normal-statured matched comparison group was tested at the baseline only.
Seventy-two children in the GHD group and 59 children in the ISS group completed 3 years of GH therapy and psychometric testing. Mean IQs of the children with short stature were near average. IQs and achievement scores did not change with GH therapy. Child Behavior Checklist scores for total behavior problems were higher (P < .001) in the children with short stature than in the normal-statured children. After 3 years of GH therapy these scores were improved in patients with GHD (P < .001) and ISS (P < .003). Also, there was improvement in the scores of children in the GHD group in the internalizing subscales (withdrawn: P < .007; somatic complications, P < .001; anxious/depressed, P < .001) and on the 3 components of the ungrouped subscales (attention, social problems, and thought problems, each P = .001). Larger effects were observed in the GHD group than in the ISS group.
Many referred children with short stature have problems in behavior, some of which ameliorate during treatment with GH.
测量身材矮小儿童中行为和学习问题的患病率，并评估生长激素（GH）治疗对此类问题的影响。
共有195名身材矮小儿童（年龄范围5至16岁，平均年龄11.2岁）在开始GH治疗前以及治疗的3年期间每年接受智力、学业成绩、社交能力和行为问题测试。当GH对激发刺激的反应<10 ng/mL时，儿童被分类为生长激素缺乏症（GHD）（n = 109）；当>10 ng/mL时，被分类为特发性身材矮小（ISS）（n = 86）。仅在基线时对一个身材正常的匹配对照组进行测试。
GHD组的72名儿童和ISS组的59名儿童完成了3年的GH治疗和心理测量测试。身材矮小儿童的平均智商接近平均水平。智商和成绩分数在GH治疗期间没有变化。身材矮小儿童的儿童行为检查表总行为问题得分高于身材正常的儿童（P <.001）。经过3年的GH治疗，GHD患者（P <.001）和ISS患者（P <.003）的这些得分有所改善。此外，GHD组儿童在内化子量表（退缩：P <.007；躯体并发症，P <.001；焦虑/抑郁，P <.001）以及未分组子量表的3个分量表（注意力、社交问题和思维问题，均为P =.001）上的得分也有所改善。在GHD组中观察到的效果比ISS组更大。
许多被转诊的身材矮小儿童存在行为问题，其中一些问题在GH治疗期间有所改善。
