中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
20期
9174-9177
,共4页
青春期发育%男子乳腺发育%来曲唑
青春期髮育%男子乳腺髮育%來麯唑
청춘기발육%남자유선발육%래곡서
Adolescent development%Gynecomastia%Letrozole
目的：评价芳香化酶抑制剂来曲唑对男童青春早期乳房发育进程及性激素水平的影响，了解其疗效及安全性。方法选择63例未经治疗的男性青春早期乳房发育症儿童，其中30例使用来曲唑2.5 mg口服6个月，另外33例未予任何相关治疗单纯临床观察6个月作为对照组。比较两组人群初诊及观察终末乳房容积大小、乳房疼痛情况、性激素水平变化及不良反应的情况。结果治疗组6个月后乳房容积缩小50%以上者有14例，对照组乳房容积缩小50%以上者有7例，两组对比，差异有显著性（χ2＝4.16，P＝0.03）。治疗组6个月后乳房疼痛全部消失，对照组仍有5例患儿诉乳房疼痛。性激素水平，6个月后治疗组E2/T下降53.5%，而对照组E2/T上升9.6%，差异具有统计学意义（t＝-8.098，P＜0.01）。相关性分析显示无论是初诊时还是治疗后E2/T与乳房容积大小均呈正相关（r＝0.454，r＝0.570，P＜0.01）。两组在6个月的观察过程中均未发现任何严重并发症。结论来曲唑治疗男童青春早期乳房发育症安全有效，雌雄激素比例失衡可能在男童青春期乳房发育发病过程中起一定的作用。
目的：評價芳香化酶抑製劑來麯唑對男童青春早期乳房髮育進程及性激素水平的影響，瞭解其療效及安全性。方法選擇63例未經治療的男性青春早期乳房髮育癥兒童，其中30例使用來麯唑2.5 mg口服6箇月，另外33例未予任何相關治療單純臨床觀察6箇月作為對照組。比較兩組人群初診及觀察終末乳房容積大小、乳房疼痛情況、性激素水平變化及不良反應的情況。結果治療組6箇月後乳房容積縮小50%以上者有14例，對照組乳房容積縮小50%以上者有7例，兩組對比，差異有顯著性（χ2＝4.16，P＝0.03）。治療組6箇月後乳房疼痛全部消失，對照組仍有5例患兒訴乳房疼痛。性激素水平，6箇月後治療組E2/T下降53.5%，而對照組E2/T上升9.6%，差異具有統計學意義（t＝-8.098，P＜0.01）。相關性分析顯示無論是初診時還是治療後E2/T與乳房容積大小均呈正相關（r＝0.454，r＝0.570，P＜0.01）。兩組在6箇月的觀察過程中均未髮現任何嚴重併髮癥。結論來麯唑治療男童青春早期乳房髮育癥安全有效，雌雄激素比例失衡可能在男童青春期乳房髮育髮病過程中起一定的作用。
목적：평개방향화매억제제래곡서대남동청춘조기유방발육진정급성격소수평적영향，료해기료효급안전성。방법선택63례미경치료적남성청춘조기유방발육증인동，기중30례사용래곡서2.5 mg구복6개월，령외33례미여임하상관치료단순림상관찰6개월작위대조조。비교량조인군초진급관찰종말유방용적대소、유방동통정황、성격소수평변화급불량반응적정황。결과치료조6개월후유방용적축소50%이상자유14례，대조조유방용적축소50%이상자유7례，량조대비，차이유현저성（χ2＝4.16，P＝0.03）。치료조6개월후유방동통전부소실，대조조잉유5례환인소유방동통。성격소수평，6개월후치료조E2/T하강53.5%，이대조조E2/T상승9.6%，차이구유통계학의의（t＝-8.098，P＜0.01）。상관성분석현시무론시초진시환시치료후E2/T여유방용적대소균정정상관（r＝0.454，r＝0.570，P＜0.01）。량조재6개월적관찰과정중균미발현임하엄중병발증。결론래곡서치료남동청춘조기유방발육증안전유효，자웅격소비례실형가능재남동청춘기유방발육발병과정중기일정적작용。
Objective To study the effects of Letrozole, a potent and selective aromatase, inhibitor, on the process of recent-onset pubertal gynecomastia and sexual hormones, and to evaluate the efficacy and safety of Letrozole. Methods 63 untreated boys with early pubertal gynecomastia were enrolled. Of these patients, 30 boys were treated with oral Letrozole 2.5 mg once a day for 6 months, another 33 boys were observed for 6 months without any drugs as control group. The breast volume and pain, sexual hormone concentrations and adverse events were compared between Letrozole and control groups at baseline and endpoint levels. Results A response was defined as a 50%or greater reduction in the volume of both breasts. The response rate in Letrozole group was significant higher than that in control group (14/30 vs. 7/33,χ2=4.16, P=0.03). All the patients with breast pain were disappeared in Letrozole group, while there were 5 patients in control group still with pain after 6 months. At 6 months, the mean percent change in estradiol/testosterone(E2/T) ratio decreased 53% for Letrozole group and increased 9.6% for control group. There has statistical difference between two groups(t=-8.098, P<0.01). Correlation analysis showed there had positive correlation between E2/T and breast volume at baseline and endpoint levels(r=0.454, r=0.570, P<0.01). There were no severe adverse events observed in both groups for 6 months. Conclusion Letrozole is effective and well tolerated to treat recent-onset pubertal gynecomastia, and E2/T unbalance may play a role in pathogenic process of pubertal gynecomastia.
