Guyda H J
Department of Pediatrics, McGill University, Montreal Children's Hospital, Quebec, Canada.
Curr Opin Pediatr. 1998 Aug;10(4):416-21. doi: 10.1097/00008480-199808000-00016.
A summary of the majority of the available uncontrolled studies of 322 children with idiopathic short stature treated with growth hormone showed that the final height attainment over predicted adult height was only +2.85 cm (+0.49 SD score). Furthermore, a summary of seven studies reported that the spontaneous outcome in children with untreated idiopathic short stature was more than +1 SD score in final height compared to height at presentation; patients with delayed puberty spontaneously gained more than +2 SD score as adults. Recent reevaluations have concluded that short stature is not associated with clinically significant psychologic morbidity, and the psychologic outcome in response to growth hormone treatment of the short normal child showed no discernable difference in psychologic benefit, despite a difference in height gained. A recent editorial has strongly advised against the expanded use of growth hormone in the normal short child.
对322例接受生长激素治疗的特发性身材矮小儿童进行的大多数现有非对照研究的总结表明,最终身高超过预测成人身高仅为+2.85厘米(+0.49标准差评分)。此外,七项研究的总结报告称,未经治疗的特发性身材矮小儿童的自发最终身高结果与就诊时身高相比,超过+1标准差评分;青春期延迟的患者成年后自发增加超过+2标准差评分。最近的重新评估得出结论,身材矮小与临床上显著的心理疾病无关,对正常身材矮小儿童进行生长激素治疗的心理结果显示,尽管身高增加有所不同,但心理益处没有明显差异。最近一篇社论强烈建议不要在正常身材矮小儿童中扩大使用生长激素。