性早熟女童血清睾酮与性激素结合球蛋白检测结果分析

Analysis of serum testosterone and sex hormone-binding globulin in sexual precocity girls

目的了解特发性中枢性性早熟(ICPP)和单纯性乳房早发育(PT)女童血清睾酮(T)、游离睾酮(FT)和性激素结合球蛋白(SHBG)水平,为开展儿童青少年青春发育期研究提供参考。方法选取2000-2007年杭州师范大学附属医院儿科内分泌门诊诊治的ICPP和PT女童各16例为研究组,正常青春期女童和正常青春期前女童各16例为对照组。所有受试者采用放射免疫分析法测定血清T,FT,SHBG和雌二醇(E2),计算FT/T。结果 ICPP组与正常青春期女童组的E2和T水平高于PT组和正常青春期前女童组(P值均<0.05);PT组的FT水平和FT/T高于正常青春期女童组、ICPP组和正常青春期前女童组(P值均<0.05);PT组的SHBG水平低于正常青春期前女童组(P<0.05),而与ICPP组和正常青春期女童组差异无统计学意义(P>0.05)。结论女童PT与血清SHBG降低有关,具有生物活性的游离性激素的升高是导致女童发生PT的重要因素。血清FT的水平和FT/T有助于PT和ICPP的鉴别。

Objective To investigate the level change and clinical significance of serum testosterone （T） , free testosterone （FT） and sex hormone-binding globulin （SHBG） in idiopathic central precocious puberty （ICPP） and simple premature thelarche （PT） girls. Methods 16 ICPP and 16 PT girls were selected as the study group, 16 normal adolescent girls and 16 normal preadolescent girls were designated as control group. All subjects were measured for serum T, FT, $HBG, and estradiol （ E2 ） using radioimmunoassay （ RIA ） , and FT / T was calculated. Results Levels of E2 and T in ICPP group and normal adolescent girls group were higher than those in PT group and normal pre-adolescent girls group（ P〈0.05）. Level of FT and FT / T in PT group were higher than those in the normal adolescent girls group, ICPP group and the normal pre-adolescent girls group （ P〈O. 05 ）. The level of SHBG in PT group was lower than normal pre-adolescent girls group （ P〈0.05 ） , while no significant difference was found among the ICPP group, PT group and normal adolescent girls （ P〉O. 05 ）. Conclusion Premature thelarche （ PT） in girls is closely associated with serum SHBG decreasing, and the increase of free sex hormones with biological activity is an important factor results in the simple premature thelarche in girls. Furthermore, serum level of FT, and FT / T could contribute to distinguishment between PT and ICPP.