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目的:观察小阴茎患儿使用 hCG 治疗前后阴茎、睾丸及性激素变化规律,探讨针对不同病因采取适当治疗方案。方法:采用自身用药前后对照设计,排除合并隐睾、隐匿性阴茎、埋藏阴茎及两性畸形等有外阴畸形的患儿,共纳入29例阴茎形态正常,尿道开口于阴茎尖端之患儿。诊断标准:静息状态下学龄前儿童阴茎小于1.5cm(L)×0.8cm(Φ),学龄儿童小于3.0cm(L)×1.0cm(Φ)。所有患儿先用游标卡尺测定静息状态下阴茎及睾丸大小,放射免疫法测定睾丸酮(T)、促黄体素(LH)、促卵泡素(FSH)。使用 hCG 1000U,im,每周2次,共5周,停药后1个月再观察上述指标。结果:所有患儿在使用 hCG 一个疗程后,其睾丸均有明显增大,有显著性差异(P<0.01),62.1%(18例)的患儿血 T 浓度及阴茎长度均有明显增加(P<0.05),9例(31.0%)患儿血 T 及阴茎改变不明显(P>0.05),另有2例(6.9%)患儿血 T 升高(P<0.05)而阴茎改变不显(P>0.05)。结论:对于小阴茎患儿应加强其临床和内分泌观察,给予 hCG 治疗可得到较满意的效果。
Objective: To observe the changes of penis, testis and sex hormones before and after hCG treatment in children with small penis and to explore appropriate treatment for different causes. Methods: A total of 29 children with genital malformations, including normal cryptorchidism, concealed penis, buried penis and hermaphroditism, were excluded from the study. Diagnostic criteria: Preschool children with penis less than 1.5cm (L) x 0.8cm (Φ) at rest and less than 3.0cm (L) x 1.0cm (Φ) in school-age children. All children with penis caliper at rest to determine the penile and testicular size, radioimmunoassay testosterone (T), luteinizing hormone (LH), follicle stimulating hormone (FSH). The use of hCG 1000U, im, twice a week for 5 weeks, one month after the withdrawal of the above indicators. Results: All the children had a significant increase in testis after a course of hCG treatment (P <0.01), and 62.1% (18 cases) of children had marked increase in blood T concentration and penis length (P <0.05). There were no significant changes in blood T and penis in 9 cases (31.0%) (P> 0.05), and in 2 cases (6.9% (P> 0.05). Conclusion: For small penile children should strengthen their clinical and endocrine observations, given hCG treatment can be more satisfactory results.