NORMAL GROWTH AND DISORDERS OF GROWTH IN CHILDREN AND ADOLESCENTS
NORMAL GROWTH AND DISORDERS OF GROWTH IN CHILDREN AND ADOLESCENTS
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DOI：
10.1007/bf02310972
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发表时间：
1981-01-01
期刊：
影响因子：
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通讯作者：
PRADER, A
中科院分区：
文献类型：
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作者：
PRADER, A
根据新的苏黎世标准百分位数图表讨论了正常生长及其变异性。在围产期，男孩比女孩长得快，可能是因为血浆睾酮浓度较高。在6-7岁时，有一个适度的中期生长突增，可能是由肾上腺雄激素分泌增加引起的（肾上腺初显）。在青春期之前，生长速度达到最低点。其次是青春期生长突增，女孩的平均年龄为12岁，男孩为14岁。这种生长突增在男孩中更为明显，是由性腺类固醇分泌增加（性腺初长）引起的。三到四年后，生长停止，生长和骨成熟密切相关。在青春期生长突增和骨骼成熟方面，女孩比男孩提前两年。从身高和骨龄可以相当准确地估计青春期的时间和成年身高。身高和生长速度是独立的多因素变量。大多数生长问题是由身高（家族性矮小或高大身材）和生长和成熟速度（家族性生长和青春期加速或延迟）的体质（家族性）变异引起的。唐氏综合征）、畸形综合征（例如，Russell-Silver综合征）、内分泌疾病（例如，低血压性侏儒症），慢性疾病（例如，乳糜泻），和骨发育不良（例如，软骨发育不全）。
Normal growth and its variability are discussed on the basis of the new Zürich standard percentile charts. In the perinatal period boys grow faster than girls, presumably because of the higher concentration of plasma testosterone. At the age of 6–7 years there is a modest midgrowth spurt, presumably caused by the increasing secretion of adrenal androgens (adrenarche). Just before puberty growth velocity reaches its lowest point. This is followed by the pubertal growth spurt with its peak at a mean age of 12 years in girls and 14 years in boys. This growth spurt is more marked in boys and is caused by the increasing secretion of the gonadal steroids (gonadarche). Three or four years later growth ceases.Growth and bone maturation are closely related. In both the pubertal growth spurt and bone maturation girls are two years advanced compared to boys. From height and bone age a quite accurate estimation of the timing of puberty and of adult height can be made.Height and growth velocity are independent multifactorial variables. The majority of growth problems are caused by constitutional (familial) variants of height (familial short or tall stature) and of velocity of growth and maturation (familial acceleration or delay of growth and adolescence).The causes of growth disturbances of organic origin are chromosomal aberrations (e.g., Down syndrome), dysmorphology syndromes (e.g., Russell-Silver syndrome), endocrinopathies (e.g., hypopituitary dwarfism), chronic diseases (e.g., celiac disease), and bone dysplasias (e.g., achondroplasia).