With the development of society and the improvement of people's living standard, the number of children with short stature is gradually incr
With the development of society and the improvement of people's living standard, the number of children with short stature is gradually increasing, especially during the holidays. In the clinic, many parents of children with short stature have such questions: what needs to be done? What is the purpose of these tests? Parents concerned about the child's height, however, if you do not understand the medical knowledge in this area, did not do a good job before the preparation, often can not be reasonable arrangements for inspection, resulting in a waste of time. In addition, visit parents' problem are hoping to get physicians to answer, but due to limited outpatient treatment time, may not be in detail, so here I visit short child processes and attention to issues related matters, do some answers for parents and children reference. The Second Affiliated Hospital of Xi'an Jiao Tong University School of Medicine Department of Pediatrics Xiao Yanfeng
First of all, height, weight, height, take off shoes, stand straight, relax. Reason: through the hospital professional measurement of height instruments, accurate measurement of the child's height, accurate. Then, the history of the family, parental height, maternal pregnancy, child birth history, past illness and medication history, etc.. Then the physical examination: including intelligence, face, body shape, body proportions, and vital organs examined, secondary sexual characteristics check.
In the laboratory is down: the blood and urine routine, liver and kidney function, blood glucose; the bone age; the head MRI examination (see pituitary pituitary size and no lesions); thyroid function, insulin-like growth factor -1, insulin-like growth factor binding protein -3 test; the growth hormone stimulation test; 6 chromosome check (if necessary); and B ultrasound examination of adrenal gland (if necessary).
So why do these checks?
1, age: children with short stature, the left wrist metacarpophalangeal mammography (bone slices), in order to understand the bone age, determine the child bone growth, epiphyseal closure (if the extent of epiphyseal closure, there is no treatment) and growth potential, especially through a detailed assessment of bone age and predicted adult height it is important, do not know exactly how long can the treatment, in order to know whether you need treatment or to determine the more reasonable treatment plan.
2, blood routine, liver and kidney function, blood glucose and hormone: check whether chronic disease, hypothyroidism caused by short stature; if there is abnormal liver function that should be used with caution or disable the growth hormone, because growth hormone through the liver metabolism, will increase the burden on the liver; impaired fasting glucose to identify the cause of the first treatment or blood sugar problems.
3, growth hormone stimulation test: growth hormone secretion in vivo was pulse, the usual value is very low, only 3 ~ 5 peak during deep sleep at night, nighttime blood child may wake up, a long time and the number of blood, so do not use. The peak value of blood sampling can not be detected, and the growth hormone is not normal.
What is the growth hormone provocation test?
A. in the morning without exercise, fasting. Before the start of the test, fasting and water deprivation were tested. B. two kinds of drug provocation test (to avoid a false positive drug as excitation test has 15%) drugs include insulin, clonidine and arginine, levodopa, two kinds of drugs, one is to stimulate growth hormone releasing hormone drugs, another for inhibition of growth hormone release inhibiting hormone drugs. C. route of administration: oral and intravenous administration. Two methods of oral administration and intravenous administration were used to reduce the effect of oral administration on oral administration. D. excitation test time and number of blood collection: blood samples were collected before the first determination of basal growth hormone values, 30, 60, and 90 minutes after the blood were taken to measure growth hormone values. E. results: any GH peak is more than 10ng/ml; GH peak < 5ng/ml is the complete lack of 5ng/ml< < GH peak; 10ng/ml as part of the lack of. (Note: the lack of completeness is different from the partial, not the body has no growth hormone)
4, chromosome, magnetic resonance: immature girls also check the chromosome to exclude "congenital ovarian hypoplasia (Turner syndrome)," a very few boys may also need to check the chromosome. It is generally necessary to examine the pituitary magnetic resonance (MRI) or CT in order to rule out inappropriate factors such as pituitary tumors.
I hope the above can help you parents.
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