儿童高身材的评估与管理

慕佳霖; 陈志红

doi:10.16766/j.cnki.issn.1674-4152.003262

儿童高身材的评估与管理

doi: 10.16766/j.cnki.issn.1674-4152.003262

慕佳霖,
陈志红^,

青岛大学附属医院儿童内分泌消化科，山东青岛 266000

详细信息

通讯作者:
陈志红，E-mail：chchch96@sina.com

中图分类号: R179
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- 被引次数: 0
出版历程
- 收稿日期: 2022-12-26
- 网络出版日期: 2024-01-13

Evaluation and management of tall stature in children

MU Jialin,
CHEN Zhihong^,

Department of Pediatric Endocrinology Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China

摘要

摘要: 高身材是指身高超过同种族、同年龄、同性别正常儿童平均身高2个标准差或第97百分位；或者身高超出遗传靶身高2个标准差以上。社会对高身材的接受度普遍较高，甚至高身材有明显优越感，因此临床关注度远低于矮身材。与矮身材类似，高身材可以出现在生长过程的各个时期，大多数为良性过程，部分为正常生长模式的变异或内分泌紊乱所致，部分可能是过度生长综合征临床表现之一，并且伴有多种发育异常，甚至罹患肿瘤风险高，需要引起临床医生重视。详细的病史采集、全面查体和相关的辅助检查，对评估儿童高身材原因至关重要。目前国内外无高身材诊治指南和共识，没有统一干预指征和措施，多以降低成年终身高和改善心理焦虑为目标。口服性激素或经皮股骨远端及胫腓骨近端骨骺闭合术是减缓生长的主要治疗措施。本文对儿童高身材的评估与管理作一综述，旨在提高临床医生对于儿童高身材的认识，帮助临床医生及早查明儿童高身材的原因，给予恰当的指导和干预，避免成年终身高受损和过度生长带来的焦虑，特别是降低肿瘤的发生风险。
- 高身材 /
- 评估 /
- 管理 /
- 儿童
Abstract: Tall stature is defined as a height more than two standard deviations (SD) above the mean for the same race, age and sex; or greater than the 97th percentile. It is also defined as the height exceeds the midparental height by more than 2 SD. There has been a high degree of acceptance for tall stature in the society, and people with tall stature even have an obvious sense of superiority. Both of above lead to a far less clinical attention to tall stature than that of short stature. Similar to short stature, tall stature can occur in various periods of growth, and mostly belong to benign process. In some cases, it can be a variation of normal growth pattern or endocrine disorder. Yet in some cases, it can be one of the clinical manifestations of overgrowth syndrome, accompanied by multiple developmental abnormalities and even high risk of cancer. Therefore, the clinician should pay attention to tall stature. Detailed history taking, general examination and relevant ancillary tests are essential to assess the cause of tall stature in children. Currently, relevant research reports in this field are seldom at home and abroad, and there is a lack of intervention indications and measures, mostly aimed at reducing excessive lifetime height and improving psychological anxiety. Oral sex hormones or epiphysiodesis are the main treatments to slow down growth. This paper devotes to make an overall review of the evaluation and management of tall stature in children, to provide appropriate guidance and intervention, to avoid anxiety associated with impaired adult lifetime height and excessive growth, and especially to reduce the risk of tumor development.
- Tall stature /
- Evaluation /
- Management /
- Children

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图 1 儿童高身材的诊断评估流程图

Figure 1. Flowchart for the diagnostic assessment of tall stature in children

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