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目的分析儿童周围性性早熟病因和临床表现,以进一步提高对本病的认识。方法对2000-01—2007-03在浙江诸暨市人民医院住院诊治的36例(男9例,女27例)周围性性早熟儿童的病因、临床状况和实验室数据进行回顾统计分析。结果周围性性早熟患儿的年龄从3.2～10.0岁,中位数为4.3岁。最常见症状是乳晕等色素沉着,占88.9%;乳房增大,占80.6%;其次分别是外阴分泌物增多(22.2%)和阴蒂/阴茎增大(19.4%)。异性性早熟最多见于先天性肾上腺皮质增生症女孩(3例)和外源性性激素摄入的男孩(3例)。病因分析发现,性腺异常(占38.9%)是最常见原因,包括12例自主性孤立性卵巢囊肿,1例卵巢支持细胞瘤,1例睾丸肿瘤。先天性肾上腺皮质增生症是男性患儿中最常见原因。外源性性激素摄入6例(占16.7%)是第3位病因。MeCune-Albright综合征1例。病因不明7例。结论周围性性早熟在儿童内分泌疾病中并不少见,多见于女孩,详细的病史、体检、实验室和影像学检查对周围性性早熟的诊断和治疗非常重要。
Objective To analyze the causes and clinical manifestations of sexual precocious puberty in children in order to further improve the understanding of this disease. Methods The etiology, clinical status and laboratory data of 36 patients (9 males and 27 females) who were hospitalized and treated in Zhuji People’s Hospital of Zhejiang Province from January 2000 to March 2007 were retrospectively analyzed. Results The age of children with precocious puberty ranged from 3.2 to 10.0 years and the median was 4.3 years. The most common symptoms were areola and other pigmentation, accounting for 88.9%; breast enlargement, accounting for 80.6%; followed by increased vulva secretion (22.2%) and clitoris / penis enlargement (19.4%). Heterosexual precocious found most often in congenital adrenal hyperplasia girls (3 cases) and exogenous sex hormone intake in boys (3 cases). Etiology analysis found that the most common causes of abnormal gonadal (38.9%), including 12 cases of autonomous solitary ovarian cysts, 1 case of ovarian tumor and 1 case of testicular tumor. Congenital adrenal hyperplasia is the most common cause of males. Six cases of exogenous sex hormone uptake (16.7%) were the third etiology. One case of MeCune-Albright syndrome. 7 cases of unknown etiology. Conclusion Peripheral precocious puberty is not uncommon in children with endocrine disease, more common in girls. Detailed medical history, physical examination, laboratory and imaging examination are very important for the diagnosis and treatment of peripheral precocious puberty.