摘要
目的 分析性早熟的临床特征,提高对该病的诊治水平。方法 收集2016年1月至2020年12月于福建省立医院内分泌科及儿科住院的34例性早熟患儿的临床资料。对其一般情况、临床表现、辅助检查结果进行回顾性分析。结果 女性30例(88.24%),男性4例(11.76%),平均年龄(6.29±1.80)岁,中位年龄7岁。4例男性患儿中有2例肾上腺肿瘤,1例视神经胶质瘤;30例女性患儿中,中枢性性早熟占86.67%(26例),外周性性早熟占13.33%(4例)。女性26例中枢性性早熟中特发性性早熟占92.31%(24例)。30例女性患儿中,中枢性性早熟(n=26)的基础促卵泡生成素(FSH)平均值、促黄体生成素(LH)平均值高于外周性性早熟(n=4),差异有统计学意义(P <0.05)。26例行促性腺激素释放激素(GnRH)刺激试验的女性中枢性性早熟患儿中,刺激后LH高峰时间:第30分钟19例(73.08%),第60分钟7例(26.92%),第90分钟及第120分钟均为0例。结论 性早熟多见于女性患儿,特发性性早熟是女性性早熟最常见的原因,男性性早熟患儿多有病理性因素。基础LH、FSH水平对中枢性性早熟的诊断有意义,GnRH刺激试验是诊断中枢性性早熟的金标准。中枢性性早熟患儿GnRH刺激试验的LH高峰时间出现在第30分钟或第60分钟,提示GnRH刺激试验可考虑简化为仅测基础及第30分钟、60分钟的LH及FSH水平。中枢性性早熟的药物治疗主要使用GnRHa。
Objective To analyze the clinical characteristics of precocious puberty and improve the diagnosis and treatment of the disease.Methods The clinical data of 34 children with precocious puberty who were hospitalized in the Department of Endocrinology and Pediatrics of Fujian Provincial Hospital from January 2016 to December 2020 were collected. The general condition, clinical manifestation and auxiliary examination were retrospectively analyzed. Results There were 30 females(88.24%) and 4 males(11.76%), with a mean age of(6.29±1.80) years and a median age of 7 years. Among the 4 male patients, 2 had adrenal tumors and one had optic glioma.Among the 30 female children, central precocious puberty accounted for 86.67%(26 cases) and peripheral precocious puberty accounted for 13.33%(4 cases).Idiopathic precocious puberty accounted for 92.31%(24 cases) of 26 female central precocious puberty. Among the 30 female children, the average basal folliclestimulating hormone(FSH) concentration and luteinizing hormone(LH) concentration of central precocious puberty(n=26) were higher than those of peripheral precocious puberty(n=4), and the differences were statistically significant(P<0.05). Among 26 female children with CPP who underwent gonadotropin-releasing hormone(GnRH) stimulation test, the timimg of peak stimulated LH was 30 minutes post-GnRH in 19 cases(73.08%), 60 minutes post-GnRH in 7 cases(26.92%), and 90 and 120 minutes post-GnRH in 0 cases. Conclusion Precocious puberty is more common in female children. Idiopathic precocious puberty is the most common cause of female precocious puberty, while male precocious puberty often has pathological factors. Basal LH and FSH concentrations are significant for the diagnosis of central precocious puberty. GnRH stimulation test is the gold standard for the diagnosis of central precocious puberty. The timimg of peak stimulated LH of GnRH stimulation test in central precocious puberty appeared at the 30 or 60 minutes post-GnRH, suggesting that GnRH stimulation test could be simpl
作者
潘金兴
PAN Jinxing(Shengli Clinical Medical College of Fujian Medical University,Fuzhou 350001,China;Department of Cadre Healthcare Office,Fujian Provincial Hospital,Fuzhou 350001,China)
出处
《中国医药指南》
2022年第28期17-20,共4页
Guide of China Medicine
关键词
性早熟
中枢性性早熟
外周性性早熟
GnRH刺激试验
临床特征
Precocious puberty
Central precocious puberty
Peripheral precocious puberty
Gonadotropin-releasing hormone(GnRH)stimulation test
Clinical Characteristics
