CAJ | 학술논문

目的：分析儿童乳房发育的临床特点。方法详细询问789例以乳房发育为主诉的患儿第二性征出现的时间、生长速率及外源性激素接触情况，分析其乳房发育的病因及临床特点。比较≥7岁患儿GnRH依赖组及非GnRH依赖组的子宫、卵巢、卵泡及LH基础值的差异。结果不同年龄儿童病因分别为：0～3岁患儿中，主要乳房早发育（93．72％）、误服避孕药（4．6％）；4～6岁患儿中主要乳房早发育（80．56％）、部分性性早熟（8．33％）、中枢性性早熟（5．56％）；≥7岁患儿中乳房早发育（58．87％）、中枢性性早熟（13．79％）、正常乳房发育（22．91％）。 GnRH依赖组与非GnRH依赖组的子宫、卵巢及卵泡大小、LH基础值差异有统计学意义（P＜0．05），但两者子宫均值均小于3．5 cm，卵巢容积均大于1 ml，卵泡均小于4 mm。结论不同年龄组患儿乳房发育的病因不同，除单纯乳房早发育外，婴幼儿以接触外源性激素如误服避孕药较多，而中枢性性早熟主要集中在学龄前及学龄期的儿童，特别是学龄期。了解不同年龄组病因不同为临床医生的诊断思路提供了参考。
목적：분석인동유방발육적림상특점。방법상세순문789례이유방발육위주소적환인제이성정출현적시간、생장속솔급외원성격소접촉정황，분석기유방발육적병인급림상특점。비교≥7세환인GnRH의뢰조급비GnRH의뢰조적자궁、란소、란포급LH기출치적차이。결과불동년령인동병인분별위：0～3세환인중，주요유방조발육（93．72％）、오복피잉약（4．6％）；4～6세환인중주요유방조발육（80．56％）、부분성성조숙（8．33％）、중추성성조숙（5．56％）；≥7세환인중유방조발육（58．87％）、중추성성조숙（13．79％）、정상유방발육（22．91％）。 GnRH의뢰조여비GnRH의뢰조적자궁、란소급란포대소、LH기출치차이유통계학의의（P＜0．05），단량자자궁균치균소우3．5 cm，란소용적균대우1 ml，란포균소우4 mm。결론불동년령조환인유방발육적병인불동，제단순유방조발육외，영유인이접촉외원성격소여오복피잉약교다，이중추성성조숙주요집중재학령전급학령기적인동，특별시학령기。료해불동년령조병인불동위림상의생적진단사로제공료삼고。
Objective To analyze the clinical feature of children premature thelarche .Methods The appearing time of sec-ondary sexual characteristics ,growth rate and exogenous hormone contact in 789 children who had premature thelarche were carefully questioned .The causes of premature thelarche and clinical feature were analyzed .The differences in uterine length ,ovarian volumes ,fol-licle and LH basic value between GnRH-dependent and non-GnRH-dependent children older than 7 years old were compared .Results In the 0~3 years old group ,93.72%of the children had premature thelarche and 4.6%accidently swallowed contraceptive pills .In the 4~6 years old group ,80.56%of the children had premature thelarche ,8.33%showed partial sexual precocity and 5.56%had central sexual precocity.In the≥7 years old group,58.87%of the children had premature thelarche ,13.79%had central sexual precocity and 22.91% presented normal mammary development .There were significant differences in uterine length ,ovarian volumes ,follicle and bas-al LH between the GnRH-dependent and the GnRH-non dependent groups ( P<0.05 ) .However ,the uterine length was less than 3.5 cm,ovarian volume larger than l ml and follicle less than 4 mm in the both groups .Conclusion The main causes of premature the-larche were various in different age groups .The accident swallow of contraceptive pills and exposure to exogenous hormones are major causes in addition to simple premature thelarche .Central sexual precocity is concentrated in pre-school and school-age children.It is important for doctors to analyze the causes in different age children who have premature thelarche .