4岁内单纯性乳房早发育女童性激素及LHRH激发试验研究  

Study on sex hormone and gonadotropin-releasing hormone stimulation test in the female children less than four years old with simple premature thelarche

作　　者：郭淑娟[1] 朱岷[1] 寸跃爽[1] 熊丰[1] 

机构地区：[1]重庆医科大学附属儿童医院内分泌科,400014

出　　处：《重庆医学》2012年第32期3365-3367,3371,共4页Chongqing medicine

摘　　要：目的了解4岁内单纯性乳房早发育女童的下丘脑-垂体-性腺轴的分泌特征以区别于中枢性及周围性性早熟。方法 374例患儿按照年龄分为6个组,检测促卵泡激素(FSH)、黄体生成素(LH)、催乳素(PRL)、雌激素(E2)的基础水平;其中306例行LHRH激发试验,以戈那瑞林作为激发药物,注射前及注射后30、60min抽取静脉血检测FSH和LH的激发值。结果FSH的基础水平[总平均值(4.68±2.32)mIU/mL]显著高于LH[(0.20±0.09)mIU/mL];FSH在大于0.5～1.0岁、>1.0～1.5岁2个年龄组分泌水平较高(P<0.05),随后分泌逐渐下降;LH在大于0.5～1.0岁年龄组分泌水平较高(P<0.05),之后呈逐渐下降趋势。LHRH激发试验中,FSH的激发峰值[总平均值(34.82±12.28)mIU/mL]显著高于LH[(6.71±2.93)mIU/mL],LH/FSH峰值比[总平均值(0.206±0.083)]在各年龄组之间比较差异无统计学意义(P>0.05);LH峰值在各年龄组之间比较差异无统计学意义(P>0.05),30min达到者234例(76.47%);FSH峰值在大于1.0～1.5岁、>1.5～2.0岁年龄组水平较高(P<0.05),60min达到者274例(89.54%)。E2和PRL在各年龄组比较差异无统计学意义(P>0.05)。结论 4岁内单纯性乳房早发育女童在该年龄阶段具有分泌特征。Objective To understand the secretion characteristics of hypothalamic pituitary-gonadal axis by studying the levels of sex hormone and gonadotropin releasing hormone stimulation test in lhe female children less than four years old with simple pre mature thetarche, and to distinguish from central precocious puberty and gonadotropin independent precocious puberty. Methods 374 cases were divided into six groups according to age,and we detected the contents of follicle stimulating hormone（FStt）, luteinizing hormone（LH） ,prolactin（PRL）and estadiol（Ez ）. Gonadotropin-releasing hormone agonist stimulation test was performed in the 306 cases. Gonadorelin as the stimulation drug, and blood samples were drawn at before and 30,60 mintues after goandorelin infusion for serum measurements of LH and FSH. Results The basic level of FSH（mean value was 4.68 ± 2.32 mIU/mL） was significantly higher than LH（0.20±0.09 mlU/mL） The higher level of FSH appeared in 〉0.5-1.0 age group and 〉1.0- 1.5 age group（P d0.05） ,and the higher level of LH appeared in 〉0.5-1.0 age group,from then,the seeretin levels declined. In the gonadotropin releasing hormone agonist stimulation test, the peak amplitude of FSH （mean value was 34.82± 12.28 mIU/mL）was significantly higher than LH（6. 71±2. 93 mIU/mL） ,the ratio of the peak amplitudes of LH and FSH （mean value was 0. 206±0. 083） had no statistically significant differences among the six groups（P〉0.05） ;the peak amplitude of LH appeared in the 30 mintues,and there were 234 cases（76.47 %0 ） consistent with the condition;FSH appeared in the 60 mintues, and 274 cases（89.54 % ） consistent with the condition,and the max of concentration appeared in 〉 1.0-1.5 age group and〉1.5 2.0 age group. PRL and E2 had no sta tistically significant differences among the six groups（P〉0.05）. Conclusion The levels of sex hormone in the female children less than four years old with simple premature thelarche have secretion characteristics in the age

关 键 词：乳房早发育 性腺甾类激素 LHRH激发试验 

分 类 号：R725.8[医药卫生—儿科]