Zheng Rongxiu Director of Pediatrics, General Hospital of Tianjin Medical University
In recent years, the "heightening needle", which is mainly used in medicine to treat short stature, has been regarded by some parents as "medicine for growing taller". In the past summer vacation, many parents took their children to the hospital for consultation and wanted to give them an injection.
In this regard, Zheng Rongxiu, director of pediatrics at the General Hospital of Tianjin Medical University, said that the so-called "strengthening needle" is to inject recombinant human growth hormone. Growth hormone should not be used indiscriminately, and children should not be injected if their height is not ideal. Injecting this hormone at will can not only prevent children from growing taller, but also may "bury" health risks for the body.
This hormone is not another hormone.
"Injecting human recombinant growth hormone is a medicine to treat children's short stature." Zheng Rongxiu introduced that the synthetic recombinant growth hormone is produced by the secretion and expression technology of recombinant Escherichia coli, which is consistent with the growth hormone secreted by human pituitary gland in amino acid content and protein structure.
Speaking of hormones, people take it for granted that they will make the body fat and osteoporosis ... In this regard, Zheng Rongxiu explained that there are more than 1000 known hormones in the human body. The hormone that people usually say generally refers to glucocorticoid. Long-term use does have many side effects, such as obesity, osteoporosis, and inhibition of children's growth. This kind of hormone is not suitable for long-term use in children.
Growth hormone is a peptide hormone secreted by the anterior pituitary gland and consists of 19 1 amino acid. Can promote bone growth, anabolism and protein synthesis, and promote lipolysis. It is an indispensable hormone for children's height growth.
"It can be seen that although growth hormone is also called hormone, it is completely different from glucocorticoid in terms of source, chemical structure and physiological and pharmacological effects, and will not produce the above side effects." Zheng Rongxiu said.
Since growth hormone can promote growth, with few side effects and high safety, can it be given to children?
"For short children who meet the indications, human recombinant growth hormone can promote height growth and improve adult height." Zheng Rongxiu said that its effectiveness and safety depend on the etiology of children's short stature, age at the time of treatment, bone age, genetic target height (indicating their growth potential) and overall health level. In the course of treatment, it is necessary to closely monitor and constantly adjust the dose to ensure effectiveness and safety.
I can't even hit the needle if I want to.
Zheng Rongxiu introduced that the effect of growth hormone on promoting height is only effective for children with epiphysis. When the bone age of girls reaches 14 to 15, and the bone age of boys reaches 16 to 17, the epiphysis is basically closed, even if the growth hormone is injected, it will not help.
Some children's height is within the normal range. According to the growth curve, it is predicted that the child's height at the age of 18 is about 1.7 meters, but the parents are not satisfied and still apply for injection of "heightening needle". There are also some parents, because their children will be engaged in basketball, modeling and other occupations with special requirements for height in the future, so they hope to let their children grow a few centimeters by injecting "heightening needles".
"In principle, if the epiphysis is not closed, injection of growth hormone can grow taller again." Zheng Rongxiu said, however, judging who needs to be injected with this growth hormone is a very professional problem, and you can't fight if you want.
Children's height growth is influenced by many factors, including genetic factors, environmental factors and nutritional factors. In medicine, there is a strict definition to judge whether you are short or not, which is not as simple as "half a head shorter than the children living at home next door". In addition, when evaluating height, we should also look at the growth rate. Children under 3 years old grow less than 7 cm a year, children from 3 years old to pre-puberty grow less than 5 cm a year, and adolescent children grow less than 6 cm a year, which is regarded as growth retardation.
"If you suspect that your child is short or stunted, parents should first take the child to the hospital, ask a professional doctor to conduct a comprehensive evaluation, fully understand the child's growth and development, growth curve, bone age and other information, and do a series of tests to determine the reason for short stature." Zheng Rongxiu said.
Bone age examination, that is, whether the bone age is consistent with the actual age, infers whether the subject has potential diseases. In general, with the increase of age, bone age will increase accordingly. Patients with precocious puberty usually have significantly earlier bone age. Although their actual height is obviously higher than their peers according to their age, if they are evaluated according to their bone age, their height often falls behind; The bone age of patients with delayed puberty or hypogonadism often lags behind for several years. When the actual age does not match the bone age, the growth potential and development state should be judged according to the bone age.
"If there is a clear primary disease through professional examination, such as various systemic chronic diseases (tumors, rheumatic immune diseases, allergic diseases), thyroid hormone deficiency, adrenal cortical hormone deficiency or increase, etc. Treat these diseases first and then consider the height problem. " Zheng Rongxiu explained.
According to reports, the common diseases that can be treated with growth hormone in pediatrics at present are: idiopathic growth hormone deficiency, idiopathic short stature, Turner syndrome and so on. "Even short children who meet the indications need a comprehensive evaluation before considering the application of growth hormone." Zheng Rongxiu said that some patients may not be suitable for using growth hormone or the application is ineffective, and may even induce tumors after injecting hormone.
The data show that the adverse reactions related to growth hormone therapy at present include benign intracranial pressure increase, impaired glucose metabolism, hypothyroidism, pigmented nevus, enlarged hands and feet, local redness, rash, otitis media and so on. Some children will have femoral head slippage and scoliosis after injecting growth hormone.
According to experts in the industry, due to different preparations, weights and sensitivities, the cost of injecting growth hormone into children every month is between 3,000 yuan and15,000 yuan, which often takes 2 to 5 years.
Growth and development should follow objective laws.
Every parent hopes that their children can grow taller quickly, but if they don't understand the development law of their children or accelerate their growth excessively, then the children will not only grow taller, but also cause precocious puberty, and eventually the epiphysis will close prematurely, leading to short stature of adults.
"Parents should understand the normal law of children's height growth. For example, the average body length at birth is about 50 cm, the average growth in the first year is 25 cm, the second year is about 10 cm, and the third year is about 8 to 9 cm. After the age of 3, it is about 5 to 6 centimeters per year before puberty. After puberty, girls are about 7 to 9 centimeters a year, and boys are about 8 to 65,438+00 centimeters. " Zheng Rongxiu said that if the child's growth is found to be off track or the growth rate is declining, he should go to the pediatric endocrinology department or the growth and development specialist clinic to give the child a comprehensive examination and determine the cause before treatment. Never use drugs blindly.
In sharp contrast to parents who are anxious about their height, a group of parents believe in "twenty-three and one channeling". Even if you find that your child is shorter than his peers or his height is not up to standard, you will not take your child to see a doctor. They always think that the baby grows late, "it will catch up in a few years."
In this regard, Zheng Rongxiu said that there are indeed individual differences in children's growth and development, but at present, because children's nutrition is sufficient, the probability of growing late is relatively low, and most children will grow to the corresponding height at the corresponding age. Especially if the child is not picky about food and anorexia, but his height is short, then the possibility of growing taller in the next few years is very small. Many parents of short children only take their children to see a doctor when their puberty development is completed and their height stops growing. At this time, the epiphysis is closed and the treatment opportunity is missed.
"Although heredity is the main factor determining height, the height of parents has a great influence on the height of children, but the acquired factors are also very important. Reasonable nutrition, proper exercise, adequate sleep and a relaxed and happy environment are all conducive to the normal growth of children's height. "Zheng Rongxiu suggested, first of all, to ensure adequate sleep, especially during the period of strong growth hormone secretion (22: 00 pm to 3: 00 am the next day), so that children can maintain a deep sleep state; Secondly, to ensure adequate and balanced dietary intake, the daily diet should include protein, fat, vitamins, carbohydrates and trace elements; Finally, children should be allowed to exercise every day for at least 20 to 40 minutes at a time.