4岁内儿童性早熟57例

Analysis of 57 Children less than 4-Year-Old with Sexual Precocity

目的探讨4岁内儿童性早熟的病因、诊断要点,研究简易的促性腺激素释放激素(GnRH)激发试验的可行性.方法对57例＜4岁性早熟患儿的临床资料进行回顾性分析.57例均行GnRH激发试验,对中枢性与部分中枢性组患儿的LH值进行秩和检验.结果本组男3例,女54例.外周性性早熟36例(63.1%);中枢性性早熟(CPP)4例;部分性CPP 17例.CPP促黄体生成素(LH)升高为甚,50%峰值落在60～90 min,部分性CPP促卵泡生成素(FSH)升高为甚,84.2%峰值落在90～120 min;CPP与部分性CPP 30、60、90、120minLH比较有显著差异(P均＜0.01).结论＜4岁儿童性早熟以女性发病为主,多为外周性性早熟.GnRH激发试验对病因分类很必需,应在0、60、120 min测LH、FSH,以明确CPP和部分性CPP.

Objective To analyze the characteristics and diagnosis of children aged 〈 4 years with .sexual precocity, and to estimate the value of a simple gonadotropin releasing horrnone（GnRH） stimulation test in diagnosing this kind of disease. Methods Fifty - .seven cases aged 〈4 years were reviewed retrospectively. The GnRH stimutation test were established in all the 57 cases. Rank sum test was used to analysis the difference of luteinizing hormone（LH） valne between central partial central precocious puberty. Results Thirtyfour patients were diagnosed as peripheral precocious puberty（55.9 % ）. Three patients were boys, the others were girls, and the level of LH was high in central precocious puberty, and 50 % peak vale fell between 60 - 90 minutes. The level of follicle stimulating hormone （FSH） was higher in partial central precocious puberty, and 84.2% peak vale fell between 90 - 120 minutes. There were significant differences of LH levels between central and partial central precocious puberty in 30,60,90,120 minutes（All P〈0.01 ）. Conclusions The morbidity of ,sexual precocity in children whose age 〈4 years is low,and the morbidity in girls are higher than that in boys. Most of the patients are peripheral precocious puberty. The GnRH stimulation test is necessary for clarification. The levels of LH, FSH in 0, 60,120 minutes are suggested to be tested to differentiate central and partial central precocious puberty.