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目的 对205例身高低于同龄及同性别正常儿童均值减2个标准差或第三百分位数以下儿童进行临床研究。方法 采用统一调查表进行病史询问、体格检查、各项辅助检查和治疗。结果 205例矮小儿童中垂体性侏儒75例为36.6％,其身高、骨龄均显著落后,其中64.0％(48/75)有臀位、横位等难产窒息史,r-hGH治疗效果显著;非垂体性侏儒91例为44.4％(91/205),其中甲状腺功能低下、体质性生长发育延迟及脑发育不全占70例,为76.9％(70/91),甲状腺功能低下者骨龄显著落后于其他非垂体性侏儒,甲状腺素替代治疗效果满意;遗传性疾病39例,为19.0％(39/205),骨龄均正常,其中21-三体综合征28例,为71.8％(28/39),智力低下较其他遗传性疾病明显。结论 矮小儿童中以垂体性侏儒、非垂体性侏儒和遗传性疾病常见。避免臀位等难产窒息、开展产前诊断及新生儿筛查是必要的。
Objective To study the clinical research of 205 children whose average height is lower than that of normal children of the same age and same sex minus two standard deviations or the third percentile. Methods A unified questionnaire for medical history, physical examination, the auxiliary examination and treatment. Results There were 75 cases of pituitary dwarfism in 205 cases of short children, whose height and bone age were significantly behind. Among them, 64.0% (48/75) had history of dystocia and asphyxia, and r-hGH had a significant therapeutic effect. 91 cases of pituitary dwarf 91.4% (91/205), of which hypothyroidism, delayed growth and development of the body and 70 cases of hypoplasia, accounting for 76.9% (70/91), significantly lower than those with hypothyroidism Non-pituitary dwarf, thyroid hormone replacement therapy was satisfactory; 39 cases of genetic diseases, 19.0% (39/205), the bone age were normal, including 21 cases of trisomy 21, accounting for 71.8% (28/39) Mental retardation than other genetic diseases significantly. Conclusion Dwarf children with pituitary dwarf, non-pituitary dwarf and genetic diseases common. Avoid breech dystocia and other asphyxia, to carry out prenatal diagnosis and neonatal screening is necessary.