The Retrospective Analysis Of60Cases Of Short Stature

[Background] Short stature means that patientsd’s height is below-2standard deviation score,or below the third percentile,in a particular environment.In endocrine and metabolic diseaes,the common etiologies of short stature are the following.growth hormone deficiency,constitutional growth and development delayed,idiopathic short stature syndrome,hypothyroidism and the chromosome aberration disease,etc.Through asking for the history,gathering the information and a series of clinical laboratory examination,we should identify the etiology clearly and distinguish the physiological variants and potential disease.Correct clinical diagnosis of short stature is extraordinary important.[Objective]60cases of short stature of hospitalized patients in recent5years with clinical data were analyzed retrospectively, in order to understand the prevalence of different cause, analyse the relevant factors that affect height growth, evaluate the therapeutic effect of human growth hormone or recombinant human growth hormone,and provide reference for the clinical diagnosis and treatment.[Method] Collecting60cases of "short stature" patients clinical data in our hosipital in nearly5years,there are46cases of men and14cases of women.Patients’data were retrospectively analyzed,such as their mother’s pregnancy history,their birth weight and height,diet habits,history of chronic disease history of TB infection,whether long-time using of hormones and other drugs which affect bone metabolism.We do statistical analysis of GH, TSH, FSH, LH, ACTH, TO and height grouped by etiology, and confirme the age of different sex,the relation between patients’height and their parental height,using SPSS18ststistical software.With follow-up of20cases of the using growth hormone replacement therapy in patients with growth hormone deficiency, we evaluates the effectiveness of the replacement therapy.[Results] In60patients there were25cases growth hormone deficiency(GHD),22cases delayed puberty,7cases idiopathic short stature(ISS),4cases hypo- thyroidism,lcase Kallman syndrome and1cases Tunner syndrome.MR images and clinic data of17patients with growth hormone deficiency are gethered,Normal pituitary was observed in6patients.Anterior pituitary lobe hypoplasia were showed in5cases.Pituitary stalks interruption was showed in4patients. Rathke’s cyst was observed in2cases.Empty sella was presented in2cases.One of them has Anterior pituitary lobe hypoplasia and Pituitary stalks interruption.The diagnosed age of different etiology group has no statistical diffrence.Comparing height of different causes,patients with hypothyroidism height behind the most obvious, and the difference was statistically significantBut all height of children are not related with their parent’s height. With analysis the secretion of pituitary hormones(TSH, FSH, LH, ACTH) in growth hormone deficiency group, delayed puberty and idiopathic short group,the TSH level of growth hormone deficiency is highest,followed by the delayed puberty, finally to idiopathic short stature patients;theACTH、FSH and LH level of patients with idiopathic short are highest, followed by the delayed puberty, finally to growth hormone deficiency patients, but there are no statistically significant differences.Compared by FT4,growth hormone deficiency is the lowest in the three groups and delayed puberty is the highest one;but compared by GH,the highest growth hormone levels is in patients with idiopathic short stature,and growth hormone deficiency patients’GH level is the last one.At the side of TO,idiopathic short stature patients are the first one,followed with delayed puberty and growth hormone deficiency.The lowest bone age is in the growth hormone deficiency and it is the most obvious behind.[Conclusion] The causes of short stature are diverse,which is given priority to with growth hormone deficiency,followed by delayed puberty,idiopathic short stature syndrome and so on.We should ask for details of the history,gather information,complete related auxiliary examination,clear tha etiology and avoid missed diagnosis and misdiagnosis in order to achieve the purpose of early diagnosis and early treatment.MRI plays an important role of diagnosis and contribute to clear the etiology of pituitary.rhGH treatment has an effect on improving height for the GHD cases.