Treatment recommendations for short stature

1, short stature children’s treatment measures depend on its etiology Psychosomatic, renal tubular acidosis and other children in the relevant factors are eliminated, the growth rate of its height that is to see an increase in the daily nutrition and sleep security is closely related to normal growth and development. 2, growth hormone With the gene recombinant human growth hormone clinical application of a large number of accumulated experience, the current approved use of rhGH treatment of the disease gradually increased since 1985, the U.S. FDA approved rhGH treatment of growth hormone deficiency, successive approval of the disease disease are chronic renal failure (1993), congenital ovarian hypoplasia (1996-1997), Prader- Willi syndrome (2000), small for gestational age (2001), and idiopathic short stature (2003). Since most children younger than gestational age show catch-up growth in the first 2-3 years of life, and can reach a height in the range of the growth curve that is commensurate with their target height, children younger than gestational age should be followed up on a regular basis. In 2003, the FDA approved GH for idiopathic short stature, i.e.: (1) non-GH deficiency of unknown cause; (2) height is lower than the normal reference value of children of the same sex and age of 2.25 SD or more; (3) the expected adult life-long height of -2 SDS or less. (1) Dosage The domestic options are rhGH powder and water, with the latter having a slightly better growth effect. (2) Dosage The dosage range of growth hormone is large and should be individualized according to the need and observed efficacy. At present, the commonly used dose in China is 0.1-0.15IU/kg?d, 0.23-0.35mg/kg per week; for children with pubertal development, Turner’s children, children younger than the gestational age, idiopathic short stature, and some children with partial growth hormone deficiency, the applied dose is 0.15-0.20IU/(K.d) 0.35-0.46 (J.K) per week (Note: (Note: WHO labeled growth hormone 1J=30U) (3) Usage: 1 subcutaneous injection every night before bedtime, commonly used injection site for the middle 1/2 of the thigh outer, anterior side, each injection should be replaced injection point, to avoid short-term repetition and lead to subcutaneous tissue degeneration. (4) Course of treatment: the course of growth hormone treatment for short stature depends on the need, usually should not be shorter than 1-2 years, too short when the child’s benefit to its lifelong high role is not great. 3, other drugs: ① course of treatment should pay attention to calcium, trace elements and other supplements for bone growth; ② anabolic hormone: often used in conjunction with growth hormone treatment of Turner syndrome, most of the domestic use of stanozolol stanozolol, kanglilong), the commonly used dose of 0.025-0.05J / (K.d) need to pay attention to the growth of bone age; ③ IGF-1 inhibition of gonadotropic axis (GnRHa), the common dosage of 0.025-0.05 J / (K.d) need to pay attention to bone age; ③ IGF-1 gonadal axis inhibition (GnRHa), aromatase inhibitors (Letrozole, Letrozole), etc. have also been used in the treatment of short stature, there is not enough information to analyze, so it is not recommended for routine use.