2～10岁性早熟女童骨密度检测分析

Analysis of bone mineral density in precocious puberty of 2 - 10-year old girls

目的探讨性早熟对2～10岁女童骨密度的影响。方法选择2003-01—2006-01在湖南省儿童医院内分泌专科就诊的2～10岁性早熟（明确诊断、并排除影响骨代谢性疾病）女童237例，根据真、假性性早熟（CPP、PPP）分为2组，各组再按年龄组分层，采用单光子骨矿物质密度测定仪测量左手桡骨中远1／3处桡、尺骨密度（BMD），并与同龄健康女童进行对比和分析。结果CPP、PPP和健康组BMD均随年龄增长而增加，3组各年龄桡骨BMD均高于尺骨；CPP桡、尺骨BMD均相对较高，8～10岁组中CPP较对照组约高6．4％-8．6％；3组桡、尺骨BMD均在8～10岁增长加速，特别是尺骨（P〈0．05），分别较6—7岁组增长20、4％、17．8％和14．3％；以CPP组增幅最大，明显高于健康组，与健康组（6～7岁）增长比较差异有显著性（桡骨P〈0．05、尺骨P〈0．001）。PPP组则与健康女童差异不显著。结论健康女童骨矿化自9岁起开始青春期加速。CPP女童青春期尺骨生长加速的年龄提早，BMD相应增加．而PPP不像CPP那样明显影响女童的正常骨骼发育．

Objective To explore the influence of the precocious puberty to bone mineral density （BMD） in 2 - 10-year old girl. Methods A total of 237 precocious puberty girls aged 2 - 10 years without bone metabolism disease were selected randomly from the specialty endocrine outpatient service in our hospital. They were divided into two groups according to central precocious puberty（CPP） and peripheral precocious puberty（PPP）, and then each precocious puberty group was divided into four groups according to the age. All the girls were measured the BMD of the radius and ulna at 1/3 middle- far radius on left hand with single photen absorptiometry（SPA） bone mineral density instrument,and then compard with the healthy girls of the normal development of the same age group. Results The BMD of CPP,PPP and health groups all increased with the age,and the radius BMD was higher than the ulna BMD in each age group. The BMD of CPP was higher than the other two groups ,and CPP was higher than the health 6. 4 - 8. 6% among their 8 - 10 years old groups. The BMD of the radius and ulna all increased and accelerated at 8 - 10 years old in three groups, especially ulna BMD （ P 〈 0.05）.The ulna BMD of 8 - 10 years old was higher than that of 6 -7 years old,20.44%,17.77% and 14.33% in CPP,PPP and healthy group. In these three groups, the increase in CPP group was obviously higher than the other two groups,especially the healthy group. And there is a significant difference between the ulna BMD of 8 - 10-year old group in CPP and the ulna BMD of 6 - 7-year old group in the health （ radius BMD, P 〈 0. 05; ulna BMD, P 〈 0. 001 ）. But there was no obvious difference between PPP group and the healthy girls. Conclusion Bone mineralization increase in the healthy girls should have begun to accelerate since 9 years old during their adolescence. With the increase of their sex steroid hormone and the advance of their adolescence, the bone mineral content increases in CPP girls, and induces their BMD to increase correspondingly,then advances the time of ulna growth, which began to accelerate at CPP girls＇adolescence age. PPP does not advance the adolescence,and the estrogen of the peripheral source increase is mostly temporary, so it does not obviously influence the normal skeleton development of the girls as CPP.