Analysis of clinical characteristics and influencing factors of children with short stature
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摘要:
目的 了解矮小症的临床特点，并分析其影响因素，为临床防治矮小症提供理论依据。 方法 选取2021年8月—2023年3月在丽水市中医院儿科就诊的矮小症患儿122例，并选取同期发育正常的儿童124例作为对照组，比较2组临床资料，分析矮小症临床特点及影响因素。 结果 观察组体质量、BMI、骨龄和骨龄指数(BAI)分别为(27.25±4.23)kg，17.52±2.65、(9.61±1.72)岁、0.91±0.25，对照组分别为(39.36±4.62)kg，20.85±2.72、(12.89±1.68)岁、1.26±0.29，观察组均明显低于对照组(P＜0.05)；多因素logistic回归分析显示维生素D缺乏(OR=4.608)、伴有基础疾病(OR=2.529)、家族矮小史(OR=1.931)、父亲身高＜160 cm(OR=3.089)、母亲身高＜150 cm(OR=3.861)、出生半年内行混合或牛奶喂养(OR=1.876)、家庭不和睦(OR=1.966)、每周弹跳运动较少(OR=4.898)、睡眠时长＜10 h/d(OR=6.651)均是影响矮小症儿童发病的独立危险因素。 结论 矮小症儿童的体质量和骨龄等指标均低于正常身高儿童，矮小症的发病受环境和遗传等多种因素影响，临床应根据上述高危因素采取干预措施以降低矮小症的发生风险。 Abstract:Objective To understand the clinical characteristics of nanosomia and analyze its influencing factors, so as to provide theoretical basis for the prevention and treatment of short stature. Methods A total of 122 children with nanosomia in Lishui Hospital of Traditional Chinese Medicine from August 2021 to March 2023 were selected as the research object, and 124 children with normal development during the same period were selected as the control group. Clinical data of the two groups were compared, and the clinical characteristics and influencing factors of nanosomia were analyzed. Results The body weight, BMI, bone age, and bone age index (BAI) of the observation group were (27.25±4.23) kg, 17.52±2.65, (9.61±1.72) years, and 0.91±0.25, respectively, while the control group were (39.36±4.62) kg, 20.85±2.72, (12.89±1.68) years, and 1.26±0.29, respectively. The observation group were significantly lower than those of the control group (P < 0.05). Multivariate logistic regression analysis showed vitamin D deficiency (OR=4.608), accompanied by basic diseases (OR=2.529), family history of short stature (OR=1.931), paternal height less than 160 cm (OR=3.089), maternal height less than 150 cm (OR=3.861), mixed or breast-fed within six months of birth (OR=1.876), family discord (OR=1.966), less bounce exercise per week (OR=4.898), and sleep duration less than 10 h/d (OR=6.651) were independent risk factors affecting the occurrence of nanosomia in children. Conclusion The weight and bone age of children with nanosomia are lower than those of normal children. The occurrence of nanosomia is affected by many factors such as environment and heredity. Clinical intervention measures should be taken according to the above-mentioned high-risk factors to reduce the risk of nanosomia. -
Key words:
- Short stature /
- Children /
- Clinical characteristics /
- Influencing factors
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表 1 矮小症患儿组与对照组临床特点比较(x ±s)
Table 1. Comparison of clinical characteristics between nanosomia group and control group in children (x ±s)
组别 例数 体质量(kg) BMI 骨龄(岁) BAI 观察组 122 27.25±4.23 17.52±2.65 9.61±1.72 0.91±0.25 对照组 124 39.36±4.62 20.85±2.72 12.89±1.68 1.26±0.29 t值 21.433 9.724 15.131 10.132 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 
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表 2 矮小症患儿组与对照组临床资料比较
Table 2. Comparison of clinical data between nanosomia group and control group in children
组别 例数 年龄(x ±s，岁) 性别[例(%)] 添加辅食时间[例(%)] 维生素D水平[例(%)] 母亲孕期情况[例(%)] 出生胎龄[例(%)] 男 女 ≥6个月 ＜6个月 正常 缺乏 健康 患病 足月 早产 观察组 122 7.25±1.73 63(51.64) 59(48.36) 89(72.95) 33(27.05) 51(41.80) 71(58.20) 109(89.34) 13(10.66) 108(88.52) 14(11.48) 对照组 124 7.29±1.82 71(57.26) 53(42.74) 92(74.19) 32(25.81) 89(71.77) 35(28.23) 113(91.13) 11(8.87) 112(90.32) 12(9.68) 统计量 0.135a 0.783b 0.049b 22.526b 0.222b 0.210b P值 0.893 0.376 0.825 ＜0.001 0.637 0.647 组别 例数 生产方式[例(%)] 出生季节[例(%)] 伴有基础疾病[例(%)] 家族矮小史[例(%)] 父亲身高[例(%)] 母亲身高[例(%)] 剖宫产 顺产 春夏 秋冬 是 否 有 无 ≥160 cm ＜160 cm ≥150 cm ＜150 cm 观察组 122 68(55.74) 54(44.26) 75(61.48) 47(38.52) 26(21.31) 96(78.69) 18(14.75) 104(85.25) 74(60.66) 48(39.34) 67(54.92) 55(45.08) 对照组 124 71(57.26) 53(42.74) 81(65.32) 43(34.68) 11(8.87) 113(91.13) 8(6.45) 116(93.55) 95(76.61) 29(23.39) 88(70.97) 36(29.03) 统计量 0.058b 0.392b 7.448b 4.485b 7.282b 6.796b P值 0.810 0.531 0.006 0.034 0.007 0.009 组别 例数 出生半年内喂养方式[例(%)] 家庭关系[例(%)] 每周弹跳运动[例(%)] 睡眠时长[例(%)] 每日补钙[例(%)] 纯母乳 混合或牛奶 不和睦 和睦 充足 较少 ≥10 h/d ＜10 h/d 充足 不足 观察组 122 63(51.64) 59(48.36) 15(12.30) 107(87.70) 43(35.25) 79(64.75) 56(45.90) 66(54.10) 53(43.44) 69(56.56) 对照组 124 81(65.32) 43(34.68) 6(4.84) 118(95.16) 71(57.26) 53(42.74) 95(76.61) 29(23.39) 71(57.26) 53(42.74) 统计量 4.744b 4.379b 11.983b 24.469b 4.695b P值 0.029 0.036 ＜0.001 ＜0.001 0.030 注：a为t值，b为χ2值。
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表 3 变量赋值情况
Table 3. Variable assignment
变量 赋值方法 维生素D水平 缺乏=0，正常=1 伴有基础疾病 否=0，是=1 家族性矮小史 无=0，有=1 父亲身高 ≥160 cm=0，＜160 cm=1 母亲身高 ≥150 cm=0，＜150 cm=1 出生半年内喂养方式 纯母乳=0，混合或牛奶=1 家庭关系 不和睦=0，和睦=1 每周弹跳运动 充足=0，较少=1 睡眠时长 ≥10 h/d=0，＜10 h/d=1 每日补钙 充足=0，不足=1 矮小症 否=0，是=1
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表 4 影响矮小症发病的多因素logistic回归分析
Table 4. Multivariate logistic regression analysis of factors influencing the incidence of nanosomia
项目 B SE Waldχ2 P值 OR值 95%CI 维生素D缺乏 1.528 0.726 13.853 ＜0.001 4.608 1.111~19.118 伴有基础疾病 0.928 0.412 6.553 0.010 2.529 1.128~5.671 家族矮小史 0.658 0.327 3.891 0.049 1.931 1.017~3.665 父亲身高＜160 cm 1.128 0.453 7.529 0.006 3.089 1.271~7.506 母亲身高＜150 cm 1.351 0.556 8.989 0.003 3.861 1.299~1.479 出生半年内行混合或牛奶喂养 0.629 0.319 4.326 0.038 1.876 1.004~3.505 家庭不和睦 0.676 0.315 4.728 0.030 1.966 1.060~3.645 每周弹跳运动较少 1.589 0.625 10.792 0.001 4.898 1.439~16.672 睡眠时长＜10 h/d 1.895 0.826 15.997 ＜0.001 6.651 1.318~33.569 每日补钙 0.398 0.351 2.256 0.133 1.489 0.748~2.962
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