中枢性性早熟女童肺功能调查研究

Investigation of the pulmonary function in central precocious puberty

目的评价中枢性性早熟(CPP)对女童肺功能的影响。方法选择2015年1月至2017年12月在宁波妇女儿童医院就诊的CPP女童24例为CPP组,再选择同期进行健康体检年龄相近的女童24例作为对照组,评价两组发育情况,检测第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、呼气峰值流速(PEF)、最大呼气中段流量(MMEF)和呼出气一氧化氮(FeNO),并进行统计分析。结果 CPP组女童身高低于对照组,而子宫长度、体重、体质量指数(BMI)均大于对照组(t值分别为3.037、5.582、4.905,均P<0.05);CPP组有2例(8.33%)出现FEV1激发后明显增加(分别增加16.4%和17.3%),CPP组FeNO、激发前后FEV1和激发前FVC、PEF、MMEF均低于对照组(t=2.064~6.472,均P<0.05);子宫长度与激发后FEV1/FVC、MMEF均呈负相关(r值分别为-0.581、-0.473,均P<0.05),CPP诊断年龄与激发前后FEV1均呈负相关(r值分别为-0.493、-0.512,均P<0.05)。结论 CPP女童接受生长激素释放激素(GnRH)治疗后仍然出现肺功能下降和气道高反应性。

Objective To evaluate the influence of central precocious puberty（CPP）on lung function of girls.Methods From January 2015 to December 2017,24 girls diagnosed with CPP in Ningbo Women＇s and Children＇s Hospital were selected as CPP group,and then 24 cases of healthy girls were selected as control group in same period.Physical development was evaluated,and forced expiratory volume in one second（FEV1）,forced vital capacity（FVC）,FEV1/FVC,peak expiratory flow rate（PEF）,maximal mid-expiratory flow（MMEF）and exhaled nitric oxide（FeNO）were measured for analysis.Results The height of CPP group was lesser than that of control group,and uterine length,weight,BMI were higher（t value was 3.037,5.582 and 4.905,respectively,all P〈0.05）.Two cases（8.33%）complained of significant increased FEV1 after stimulation in CPP group（increasing 16.4% and17.3%,respectively）,while FeNO,FEV1 before and after stimulation,FVC,PEF and MMEF before stimulation of CPP group were lower than control group（t value ranged 2.064-6.472,all P〈0.05）.Uterine length was negatively correlated with FEV1/FVC and MMEF after stimulation（r value was-0.581 and-0.473,respectively,both P〈0.05）,and diagnosis age of CPP was also negatively correlated with FEV1 before and after stimulation（r value was-0.493 and-0.512,respectively,both P〈0.05）.Conclusion CPP girls still have lung function decreased and airway hyperresponsiveness after GnRH treatment.