【摘要】 目的 调查唐山地区4～9岁儿童矮小症检出情况，探讨病因分布与血清骨形成标志物的相关性。方法 收集2022年1月至2024年6月于唐山市妇幼保健院健康体检的4～9岁儿童19383例，筛查出生长迟缓儿童252例为病例组，同期选取116例健康儿童为对照组。用化学发光法检测血清GH、IGF-1、25（OH）D₃水平；用ELISA法检测血清中OC、BALP水平。结果 矮小症检出率为1.30%，病因主要为，特发性矮小（idiopathic short stature,ISS）131例（52%）、生长激素缺乏症（growth hormone deficiency,GHD）94例（37.3%）和营养不良性27例（10.7%）。家族矮小史、运动少和入睡晚为ISS发生的危险因素。与对照组比较，营养不良组和GHD组血清GH、IGF-1、OC、BALP水平均偏低（P<0.05）,ISS组血清IGF-1、OC、BALP水平偏低（P<0.05）。在病例各组间比较，血清GH、IGF-1水平在病例各组间差异均有统计学意义（P<0.05）；血清OC和BALP水平在ISS组中分别高于GHD和营养不良组（P<0.05）。血清GH与IGF-1水平分别在对照组、GHD和营养不良组中呈中度正相关（P<0.05）;GH与OC、BALP水平分别在对照组、GHD组中呈中度正相关（P<0.05）;IGF-1与OC、BALP水平分别在对照组、GHD组和营养不良组中呈中度正相关（P<0.05）；血清OC与BALP指标间在各组中均呈中度正相关性（P<0.05）。结论 唐山地区4～9岁儿童矮小症检出率为1.30%，病因主要为特发性、GH缺乏性和营养不良性；家族矮小史、每日运动少和入睡时间晚为ISS发生的危险因素。矮小症病因与GH-IGF-1轴机制效应存在不同程度的相关性。更多还原

【Abstract】 Objective To investigate the incidence of short stature in children aged4 to9 in Tangshan area,and to evaluate the correlation between the etiology and serum bone formation markers.Methods A total of 19 383 children aged 4-9 who underwent health check-ups in Tangshan Maternal and Child Health Care Hospital from January2022 to June 2024 were collected for the study.Among them,252 children with growth retardation were screened as the case group,while 116 healthy children were selected as the control group during the same period.The case information and physical examination data of all subjects were collected;Serum levels of GH,IGF-1 and 25（OH）D₃ were measured by chemuminescence;Serum levels of OC and BALP were measured by ELISA.Results The detection rate of short stature was 1.30%.The etiological distributions were mainly ISS in131 cases（52%）,growth hormone deficiency（GHD）in94 cases（37.3%）and malnutrition in27 cases（10.7%）.Family history of short stature,insufficient exercise and late bedtime were identified as risk factors for ISS.Compared with the control group,the levels of GH,IGF-1,OC and BALP in serum were significantly lower in the malnutrition group and GHD group（P<0.05）,respectively;The levels of IGF-1 in the ISS group were significantly lower than the control group（P<0.05）.Comparison between case groups,the levels of GH and IGF-1 in serum were significantly different among these case groups（P<0.05）.The serum levels of OC and BALP in the ISS group were significantly higher than in the GHD and malnutrition groups（P<0.05）,respectively;In the control,GHD and malnutrition groups,GH levels were positively correlated with IGF-1 levels（P<0.05）,respectively.In the control,GHD and malnutrition groups,GH were positively correlated with OC and BALP（P<0.05）,respectively.In the control,GHD and malnutrition groups,IGF-1 were positively correlated with OC and BALP（P<0.05）,respectively.The correlation between serum OC and BALP were positively correlated in all case groups（P<0.05）.Conclusion The detection rate of short stature in children aged 4 to 9 is 1.30% in Tangshan area.The main causes are ISS,GHD and malnutrition;Family history of short stature,lack of daily exercise and late bedtime are risk factors for ISS.There are various degrees of correlations between the etiology of short stature and the mechanism of the GH-IGF-1 axis.更多还原