高度重视儿童矮身材的科学评估

王琳

中国当代儿科杂志 ›› 2023, Vol. 25 ›› Issue (11) : 1095-1100.

PDF(616 KB)
HTML
PDF(616 KB)
HTML
中国当代儿科杂志 ›› 2023, Vol. 25 ›› Issue (11) : 1095-1100. DOI: 10.7499/j.issn.1008-8830.2308063
系列讲座——儿童矮身材的规范诊疗

高度重视儿童矮身材的科学评估

  • 王琳
作者信息 +

Attaching great importance to the scientific assessment of short stature in children

  • WANG Lin
Author information +
文章历史 +

摘要

矮身材是儿童常见的体格发育异常问题,若未能得到及时正确的诊断和及早干预,将会给患儿及其家庭带来沉重负担。引起矮身材的原因众多,矮身材的诊断过程实质上是其病因诊断的过程。在充分认识儿童体格发育规律和矮身材高危人群特点的基础上,通过科学界定矮身材,规范化诊疗流程,以实现矮身材的早期诊断或转诊。同时需要加强家长和基层儿科医生对矮身材的科学认识,避免“认识误区”导致的过度医疗、漏诊、误诊等问题出现,提高矮身材的科学评估。

Abstract

Short stature is a common physical developmental abnormality in children. Without timely and accurate diagnosis, as well as early intervention, it can impose a heavy burden on the children and their families. There are numerous causes for short stature, and the diagnostic process essentially involves identifying its underlying causes. Based on a thorough understanding of the regular patterns of child physical development and the characteristics of individuals at high risk of short stature, a scientific definition of short stature needs to be established, along with standardized diagnostic and treatment protocols, to achieve early diagnosis or referral for short stature. Furthermore, it is necessary to enhance scientific awareness of short stature among parents and primary care pediatricians, in order to avoid over-treatment, missed diagnoses, and misdiagnoses arising from "misconceptions", and to improve the scientific assessment of short stature.

关键词

矮身材 / 评估 / 儿童

Key words

Short stature / Assessment / Child

引用本文

导出引用
王琳. 高度重视儿童矮身材的科学评估[J]. 中国当代儿科杂志. 2023, 25(11): 1095-1100 https://doi.org/10.7499/j.issn.1008-8830.2308063
WANG Lin. Attaching great importance to the scientific assessment of short stature in children[J]. Chinese Journal of Contemporary Pediatrics. 2023, 25(11): 1095-1100 https://doi.org/10.7499/j.issn.1008-8830.2308063

参考文献

1 Li F, Liu K, Zhao Q, et al. Prevalence of short stature among children in China: a systematic review[J]. Pediatr Investig, 2021, 5(2): 140-147. PMID: 34179712. PMCID: PMC8212717. DOI: 10.1002/ped4.12233.
2 Gupta S, Dayal D, Rohit MK, et al. Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study[J]. J Pediatr Endocrinol Metab, 2022, 35(8): 1059-1068. PMID: 35822711. DOI: 10.1515/jpem-2021-0693.
3 Oh NK, Song YM, Kim SH, et al. Short stature is associated with increased risk of dyslipidemia in Korean adolescents and adults[J]. Sci Rep, 2019, 9(1): 14090. PMID: 31575921. PMCID: PMC6773853. DOI: 10.1038/s41598-019-50524-2.
4 Wittenbecher C, Kuxhaus O, Boeing H, et al. Associations of short stature and components of height with incidence of type 2 diabetes: mediating effects of cardiometabolic risk factors[J]. Diabetologia, 2019, 62(12): 2211-2221. PMID: 31501920. PMCID: PMC6861343. DOI: 10.1007/s00125-019-04978-8.
5 Kochar IS, Ramachandran S, Sethi A. Effects of early initiation of growth hormone therapy on different auxological parameters in growth hormone deficient children: experience from an Indian tertiary care center[J]. Indian J Endocrinol Metab, 2021, 25(1): 54-58. PMID: 34386395. PMCID: PMC8323637. DOI: 10.4103/ijem.IJEM_739_20.
6 Juul A, Backeljauw P, Cappa M, et al. Early growth hormone initiation leads to favorable long-term growth outcomes in children born small for gestational age[J]. J Clin Endocrinol Metab, 2023, 108(5): 1043-1052. PMID: 36469726. PMCID: PMC10099159. DOI: 10.1210/clinem/dgac694.
7 Mavinkurve M, Azriyanti AZ, Jalaludin MY. The short child: importance of early detection and timely referrai[J]. Malays Fam Physician, 2021, 16(3): 6-15. PMID: 34938388. PMCID: PMC8680933. DOI: 10.51866/rv1157.
8 健康中国行动推进委员会. 健康中国行动(2019—2030年)[EB/OL]. (2019-07-15)[2023-08-16]. http://www.gov.cn/xinwen/2019-07/15/content_5409694.htm.
9 国家卫生健康委. 国家卫生健康委关于印发健康儿童行动提升计划(2021—2025年)的通知: 国卫妇幼发〔2021〕33号[EB/OL]. (2021-10-29)[2023-08-16]. http://www.gov.cn/zhengce/zhengceku/2021-11/05/content_5649019.htm.
10 Rajput R, Rani M, Rajput M, et al. Etiological profile of short stature in children and adolescents[J]. Indian J Endocrinol Metab, 2021, 25(3): 247-251. PMID: 34760681. PMCID: PMC8547404. DOI: 10.4103/ijem.ijem_129_21.
11 Kaplan W, Al Amiri E, Attia N, et al. Assessment and referral of patients with short stature by primary care physicians in the Arabian gulf region: current perspectives from a regional survey[J]. Front Pediatr, 2022, 10: 988614. PMID: 36507126. PMCID: PMC9732663. DOI: 10.3389/fped.2022.988614.
12 Al-Abdulrazzaq D, Al-Taiar A, Hassan K, et al. Referral pattern of children with short stature to a pediatric endocrine clinic in Kuwait[J]. J Pediatr Endocrinol Metab, 2016, 29(9): 1055-1061. PMID: 27442364. DOI: 10.1515/jpem-2016-0098.
13 Maghnie M, Labarta JI, Koledova E, et al. Short stature diagnosis and referral[J]. Front Endocrinol (Lausanne), 2018, 8: 374. PMID: 29375479. PMCID: PMC5768898. DOI: 10.3389/fendo.2017.00374.
14 中华医学会儿科学分会内分泌遗传代谢学组, 中华医学会儿科学分会儿童保健学组, 中华儿科杂志编辑委员会. 儿童体格发育评估与管理临床实践专家共识[J]. 中华儿科杂志, 2021, 59(3): 169-174. PMID: 33657689. DOI: 10.3760/cma.j.cn112140-20210116-00050.
15 黄轲, 傅君芬. 儿童正常生长规律及其调控机制[J]. 中国实用儿科杂志, 2021, 36(8): 570-573. DOI: 10.19538/j.ek2021080603.
16 Yap F, Lee YS, Aw MMH. Growth assessment and monitoring during childhood[J]. Ann Acad Med Singap, 2018, 47(4): 149-155. PMID: 29777245.
17 Huang S, Chen Z, Chen R, et al. Analysis of risk factors and construction of a prediction model for short stature in children[J]. Front Pediatr, 2022, 10: 1006011. PMID: 36561487. PMCID: PMC9763591. DOI: 10.3389/fped.2022.1006011.
18 王维, 陈洋, 唐雨莉, 等. 矮小症儿童临床特征及相关危险因素分析[J]. 中国中西医结合儿科学, 2023, 15(2): 133-137. DOI: 10.3969/j.issn.1674-3865.2023.02.009.
19 Harju S, Saari A, Sund R, et al. Epidemiology of disorders associated with short stature in childhood: a 20-year birth cohort study in Finland[J]. Clin Epidemiol, 2022, 14: 1205-1214. PMID: 36320440. PMCID: PMC9618248. DOI: 10.2147/CLEP.S372870.
20 Barstow C, Rerucha C. Evaluation of short and tall stature in children[J]. Am Fam Physician, 2015, 92(1): 43-50. PMID: 26132126.
21 朱建芳, 王春林. 矮身材的诊断思路[J]. 中华全科医师杂志, 2023, 22(4): 358-361. DOI: 10.3760/cma.j.cn114798-20230130-00082.
22 Ma J, Siminoski K, Alos N, et al. Impact of vertebral fractures and glucocorticoid exposure on height deficits in children during treatment of leukemia[J]. J Clin Endocrinol Metab, 2019, 104(2): 213-222. PMID: 30247635. PMCID: PMC6291659. DOI: 10.1210/jc.2018-01083.
23 Carucci S, Balia C, Gagliano A, et al. Long term methylphenidate exposure and growth in children and adolescents with ADHD. A systematic review and meta-analysis[J]. Neurosci Biobehav Rev, 2021, 120: 509-525. PMID: 33080250. DOI: 10.1016/j.neubiorev.2020.09.031.
24 Rogol AD. Emotional deprivation in children: growth faltering and reversible hypopituitarism[J]. Front Endocrinol (Lausanne), 2020, 11: 596144. PMID: 33117295. PMCID: PMC7575787. DOI: 10.3389/fendo.2020.596144.
25 李雪, 吴瑾. 儿童生长发育障碍的识别与对策[J]. 中国临床医生杂志, 2021, 49(2): 138-141. DOI: 10.3969/j.issn.2095-8552.2021.02.004.
26 吴薇, 罗小平. 科学评估儿童和青少年体格生长发育[J]. 中华医学信息导报, 2022, 37(10): 14. DOI: 10.3760/cma.j.issn.1000-8039.2022.10.154.
27 李辉. 再论儿童生长发育的科学评估[J]. 中国儿童保健杂志, 2021, 29(6): 581-583. DOI: 10.11852/zgetbjzz2021-0771.
28 蒋竞雄, 王燕, 连光利. 儿童体格生长评价及身高保健方法[J]. 中国儿童保健杂志, 2012, 20(11): 963-965.
29 黎海芪, 毛萌. 科学评估儿童体格生长与发育[J]. 中国实用儿科杂志, 2019, 34(10): 810-814. DOI: 10.19538/j.ek2019100603.
30 田娟娟, 袁文晓, 王屹, 等. 2018年荣成市托幼机构卫生保健人员对矮身材认识度的调查[J]. 预防医学论坛, 2021, 27(7): 542-545. DOI: 10.16406/j.pmt.issn.1672-9153.2021.07.019.
31 李辉. 遗传性疾病与儿童生长发育障碍[J]. 中国儿童保健杂志, 2016, 24(10): 1009-1011. DOI: 10.11852/zgetbjzz2016-24-10-01.
32 罗小平. 身材矮小症儿童诊疗规范[M]. 北京: 人民卫生出版社, 2019: 11-12.
33 Yang M, Deng X, Wang S, et al. Identification and characterization of factors associated with short stature and pre-shortness in Chinese preschool-aged children[J]. Endocr Connect, 2021, 10(6): 607-619. PMID: 34010149. PMCID: PMC8240712. DOI: 10.1530/EC-21-0147.
34 Yuan Y, Zhou B, Wang K, et al. Identification of contributing predictors for short stature and pre-shortness among 7310 Chinese preschool-aged children[J]. Endocrine, 2021, 71(2): 443-452. PMID: 33111222. DOI: 10.1007/s12020-020-02528-6.
35 Patel RV, Bajpai AT, Mendpara HV, et al. Development and validation of a mobile application for point of care evaluation of growth failure[J]. J Pediatr Endocrinol Metab, 2022, 35(2): 147-153. PMID: 34529910. DOI: 10.1515/jpem-2021-0267.

基金

北京市医院管理中心“登峰”计划专项经费资助(DFL20221103);高层次公共卫生技术人才建设项目资助”(学科带头人-02-19)。

PDF(616 KB)
HTML

Accesses

Citation

Detail

段落导航
相关文章

/