女童乳房早发育的临床探讨  

Clinical study of girls with early breast development.

作　　者：罗丽茹 张玲 史丽琼 Luo Liru , Zhang Ling, Shi Liqiong. （ The first people＇ s hospital of Zhaoqing , Zhaoqing 526021 ）

机构地区：肇庆市第一人民医院,广东肇庆526021

出　　处：《中国保健》2007年第17期6-7,共2页Chinese Health Care

摘　　要：目的：探讨乳房早发育与中枢性、周围性和不完全性性早熟的关系。方法：详细询问病史与体查,内分泌检查,骨龄,盆腔B超检查,病情需要则作头颅MRI或CT检查,促性腺激素释放激素（GnRH）激发试验。结果：女童乳房早发育48例,诊断为中枢性性早熟（CPP）14例,周围性性早熟（PPP）21例,不完全性性早熟（单纯乳房发育）13例。CPP病例GnRH激发试验呈阳性,全部病例为特发性（ICPP）;骨龄比生理年龄超前1~3年,盆腔B超检查显示部分病例子宫、卵巢均有增大;PPP病例和不完全性性早熟病例GnRH激发试验呈阴性,骨龄除PPP部份病例有超前外,其余均与生理年龄相符,盆腔B超检查二者皆无明显变化。PPP除1例为原发性甲状腺功能低下外,大部份与经常食用肉类、禽类、水产、饮料有关。结论：乳房早发育常是各种类型性早熟最早出现的症状,故及早鉴别乳房早发育的性质,对性早熟的诊断、治疗至关重要。各类型性早熟在初期差别不明显,诊断不能依据表现,尽早作血清LH,FSH,E2检测及作GnRH激发试验,盆腔B超,可用于鉴别各种性早熟的重要指标。PPP的发病因素与多食肉类、禽类、水产、滋补品关系密切,与目前许多使用雌激素饲养家禽、水产等有关。这是一个社会食品安全的大问题,应引起广大人们的关注。Objective：To explore the relationship between early breast development and central precocious puberty, peripheral precocious puberty, and premature thelarehe. Methods ：48 cases of early breast development girls received comprehensive examination;such as ask medical history in detail, physical examination, endocrine, bone age and B - ultrasound examination; the MRI or CT examination and gonadotropin - releasing hormone （GnRH）stimulation test were performed when the disease condition needed. Results ：There were 14 cases of central precocious puberty（CPP） among all early breast development girls;peripheral precocious puberty（PPP） in 21 cases and simple premature thelarche（SPT） in 13 cases. For CPP eases, the GnRH stimulation test was positive, the bone age went beyond physiological age for 1 - 3 years, B - ultrasound showed uterus and o- vary enlarged in part eases. Then for PPP and SPT eases, the GnRH stimulation test was negative, the bone age went beyond in part eases ; there was on change in B - ultrasound examination. The PPP is related to often taking meat, avian, fishery and beverage. Conclusion： Early breast development is the earliest symptom of various type of puberty, so the identification of early breast development is very important for diagnosis and treatment of puberty. The serum LH,FSH ,E2 tests and GnRH stimulation test can use to identify various type of puberty. The PPP is related to taking meat ,avi- an,fishery and invigorant because the feed of many poultry and fishery have estrogen. This is a big social problem in foods safety and it should be paid more attention by whole society.

关 键 词：女童 乳房早发育 性早熟 骨龄 B超 促性腺激素释放激素 激素激发试验 头颅MRI CT 

分 类 号：R588[医药卫生—内分泌;医药卫生—临床医学;医药卫生—内科学]