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目的对特发性性早熟(ICPP)女童的临床特点和发病的相关性因素进行探讨,为临床诊断和治疗提供科学的依据。方法选择2014年1月—2015年3月南通大学附属海安医院儿科收治的ICPP女童45例作为研究组,选择同龄的45例正常女童作为对照组,观察和检测2组女童的一般临床特征、生理性指标、性激素水平和发病影响因素等,进行比较和分析。结果 ICPP女童乳房发育和月经初潮的平均年龄为(7.5±0.4)岁和(9.3±0.5)岁,比正常女童提前了1~3 a。ICPP女童的身高、体质指数(BMI)、瘦素、骨龄(BA)、卵巢容积、子宫容积和乳晕直径等生理性指标,均明显高于对照组女童,差异有统计学意义(P<0.05)。ICPP女童的卵泡刺激素(FSH)和黄体生成素(LH)的基础值与对照组相比较,差异无统计学意义(P>0.05);但在FSH和LH的峰值、雌二醇(E2)、垂体催乳素(PRL)和孕酮(P)等性激素水平方面,差异有统计学意义(P<0.05)。ICPP女童的生理、环境、饮食、遗传和家庭等发病率影响因素方面,与对照组相比,差异无统计学意义(P>0.05)。结论 ICPP女童的乳房发育和月经初潮年龄提前,与BMI、身高和瘦素水平明显增加,卵巢、子宫和乳房发育明显提前,FSH和LH的峰值、E2、PRL和P等性激素水平显著升高,呈明显的正相关;该研究因调查样本量小,尚不能说明ICPP女童的发病与生理、环境、饮食、遗传和家庭因素等有明显的关系。提示社会各方应重视和加强对儿童的心理和生殖健康的教育,促进其身心健康的发展;对性早熟患儿应早期发现和早期诊断,尽早给予积极有效的综合治疗,减少性早熟对患儿的不良影响。
Objective To explore the clinical characteristics and the related factors of girls with idiopathic precocious puberty (ICPP), and provide a scientific basis for clinical diagnosis and treatment. Methods Forty-five ICPP girls admitted to pediatric department of Hai’an Hospital affiliated to Nantong University from January 2014 to March 2015 were selected as the study group. 45 normal girls of same age were selected as the control group. The general clinical features, Sex indicators, sex hormone levels and the incidence of factors, for comparison and analysis. Results The average age of breast development and menarche in ICPP girls was (7.5 ± 0.4) years old and (9.3 ± 0.5) years old, 1-3 years earlier than normal girls. The ICPP girls’ height, body mass index (BMI), leptin, bone age (BA), ovarian volume, uterine volume and areola diameter and other physiological indicators were significantly higher than those of the control group girls, the difference was statistically significant (P <0.05) . There were no significant differences in the basic values of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in ICPP girls compared with the control group (P> 0.05) , Pituitary prolactin (PRL) and progesterone (P) and other sex hormones, the difference was statistically significant (P <0.05). Compared with control group, there was no significant difference in ICPP girls’ physical, environmental, diet, genetic and family incidence rates (P> 0.05). CONCLUSIONS: The age of girls’ breasts and menarche are earlier than those of girls with ICPP. The levels of BMI, height and leptin are significantly increased. The development of ovary, uterus and breast are advanced obviously. The peak of FSH and LH, the levels of E2, PRL and P are significantly increased, There was a clear positive correlation between the incidence of ICPP and the physical, environmental, dietary, genetic and family factors of ICPP girls. Prompted that all sectors of society should pay attention to and strengthen the education of children’s psychological and reproductive health and promote their physical and mental health development; Early detection and early diagnosis of children with precocious puberty, as soon as possible to give a positive and effective comprehensive treatment to reduce the precocious puberty Adverse effects of children.