浙江沿海地区性早熟的调查与研究

Investigation and research about precocious puberty in eastern coast of Zhejiang Province

目的 掌握我国沿海地区小儿性早熟的发病情况。方法 对温岭市全市范围内性早熟患儿进行临床筛查、调查性早熟儿的流行病学并进行相关分析 ,分初步筛查、临床检测及相关分析 3个阶段。检测性早熟儿卵泡刺激素 (FSH)、黄体生成素 (LH)、雌二醇 (E2 )等激素。并作黄体激素释放激素 (LHRH)试验 ,对早熟儿进行韦氏量表评分分析。对女性早熟儿行B超子宫及卵巢检查 ,并与正常同龄儿对照。探讨当地性早熟儿的流行病学 ,进行相关分析。结果 1.本地区 2 2 2 81人次筛查 ,查出阳性病例 84例。其中男 9例 [特发性性早熟 (IPP) 7例、部分性性早熟 (PPP) 2例 ],女 75例 (IPP 30例、假性性早熟 8例、PPP 37例 ) ;2 .女性IPP儿子宫、卵巢B超及FSH、LH、E2 等指标显著高于正常同龄儿 (P均 <0 .0 5 ) ,而其余患儿均基本正常。 3.早熟儿智商略低于正常儿 ,但差异不明显。 4 .生活在城镇、经济发达、污染地区、母亲初潮早、社会因素、营养状况、服用滋补药、遗传等诸多因素与性早熟有关。结论 沿海地区性早熟儿的发病率为 0 .38% ,女性性早熟发病率较高 (0 .6 7% )。B超测子宫、卵巢及FSH、LH、E2 等激素检测是女童IPP筛查简易、可靠的方法。性早熟病因复杂 ,对多影响因素进行干预 。

Objective To explore the morbidity of children′s precocious puberty in the eastern coast in China, to take reliably clinical screening, and to investigate the epidemiology of children′s precocious puberty and analyze their correlation.Methods This study included 3 stages: preliminary screening, clinical detection and correlation analysis. The levels of FSH, LH and E 2 were detected with precocious puberty, and the LHRH test was made, children were scored according to Wenz′s scale.The uterus and ovary were detected with ultrasonic detector and compared with normal children. The epidemiology of children′s precocious puberty was evaluated in these areas, and correlation analysis was made.Results 1.Among 22 281 person-time screened, there were 84 positive cases including 9 male cases [idiopathic precocious puberty (IPP) 7 cases and partial precocious puberty(PPP) 2 cases]; there were 75 female cases (IPP 30 cases, pseudo precocious puberty 8 cases, and PPP 37 cases ) .2.There was significant difference between the female with IPP and normal children in the size of uterus and ovary with ultrasound,the levels of FSH,LH and E 2 (P<0.05),whereas they were almost normal for the children with PPP and pseudo precocious puberty.3.Intelligence quotient of children with precocious puberty was slightly lower than that of normal children.but there was no significant difference.4.There may be various factors for puberty, such as urban life in industrial and polluted areas, early first menses of the mother, social environment, excessive nutrition, certain heredity factors,taking nourishment and others.Conclusions There is higher morbidity for the female (0.67 %). It is simple and reliable to detect uterus and ovary with ultrasound and test the levels of FSH, LH and E 2 for screening female IPP. There is no definite etiology for puberty, but understanding multiple factors and adopting intervention measurement may contribute to lowering the morbidity.