单纯性乳房早发育女童的临床特征及进展为中枢性性早熟的影响因素分析  

Clinical characteristics of girls with idiopathic premature thelarche and influencing factors for progression to central precocious puberty

作　　者：崔海静[1] 王霞[1] 张蔷[2] 刘新光[3] 刘朋 杜稳重[5] Cui Haijing;Wang Xia;Zhang Qiang;Liu Xinguang;Liu Peng;Du Wenzhong(Department of Child Health(Psychological Behavior),Children's Hospital of Hebei Province,Shijiazhuang 050031,China;Department of Endocrine Genetics and Metabolism,Children's Hospital of Hebei Province,Shijiazhuang 050031,China;Department of Medical Laboratory,Children's Hospital of Hebei Province,Shijiazhuang 050031,China;Department of Medical Insurance,Children's Hospital of Hebei Province,Shijiazhuang 050031,China;Department of Quality Control,Children's Hospital of Hebei Province,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院儿童保健科(心理行为科),石家庄050031 [2]河北省儿童医院内分泌遗传代谢科,石家庄050031 [3]河北省儿童医院医学检验科,石家庄050031 [4]河北省儿童医院医疗保险处,石家庄050031 [5]河北省儿童医院质量控制处,石家庄050031

出　　处：《保健医学研究与实践》2024年第4期15-19,共5页Health Medicine Research and Practice

基　　金：河北省医学科学研究课题计划项目(20190800)。

摘　　要：目的探讨单纯性乳房早发育(IPT)女童的临床特征及进展为中枢性性早熟(CPP)的影响因素。方法选取2017年1月—2021年12月于我院首诊的85例IPT女童为研究对象,根据1年内是否进展为CPP分为进展组与未进展组,比较2组患儿的临床随访资料。采用Logistic回归分析IPT患儿进展为CPP的独立影响因素;采用受试者工作特征(ROC)曲线来分析相关指标对患儿进展为CPP的预测价值。结果全部患儿中,1年内共有20例进展为CPP,发生率为23.5%。进展组患儿的发病年龄,身高、体质量及身体质量指数(BMI)的标准差评分,Tanner分期为3期的比例,骨龄与实际年龄的比值,子宫长径,血胰岛素样生长因-1(IGF-1)水平均明显大/高于未进展组(P<0.05);进展组患儿的母亲初潮年龄小于未进展组(P<0.05)。Logistic回归分析结果表明,Tanner分期、血IGF-1水平、子宫长径是IPT患儿进展为CPP的独立影响因素(P<0.05)。ROC曲线分析结果表明,IPT患儿初诊时的IGF-1水平与子宫长径对其1年内进展为CPP具有较高的预测价值,其曲线下面积(AUC)分别为0.789、0.729(P<0.05)。结论IPT女童进展为CPP并不少见,与Tanner分期、血IGF-1水平、子宫长径等有关,临床上应加强对高危患儿的随访干预。Objective To investigate the clinical characteristics of girls with idiopathic premature thelarche(IPT)and the influencing factors for progression to central precocious puberty(CPP).Methods A total of 85 girls with IPT,first diagnosed at our hospital between January 2017 and December 2021,were selected as the study participants,who were assigned to a progression group and a non-progression group based on whether they progressed to CPP within one year.Clinical follow-up data of the two groups were compared.Logistic regression was used to identify independent influencing factors for IPT progression to CPP,and ROC curves were used to assess the predictive value of related indicators for CPP progression.Results Among all participants,20 cases progressed to CPP within one year,with an incidence rate of 23.5%.The progression group showed younger age at onset,higher standard deviation scores for height,weight,and BMI,higher proportion of Tanner stage 3,higher bone age-to-chronological age ratio,longer uterine length,and higher blood IGF-1 levels compared to the non-progression group,all with statistical significance(P<0.05).Mothers of the progression group had a significantly earlier age at menarche than those of the non-progression group(P<0.05).Logistic regression analysis indicated that the Tanner stage,blood IGF-1 level,and uterine length were independent influencing factors for IPT progression to CPP(P<0.05).ROC curve analysis indicated that IGF-1 level and uterine length at initial diagnosis had high predictive value for CPP progression within one year,with AUCs of 0.789 and 0.729,respectively(P<0.05).Conclusion Progression from IPT to CPP is not uncommon in girls and is associated with the Tanner stage,blood IGF-1 level,and uterine length.

关 键 词：单纯性乳房早发育 中枢性性早熟 影响因素 胰岛素样生长因-1 

分 类 号：R725.8[医药卫生—儿科]