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目的探讨女童真性性早熟和假性性早熟的早期鉴别及预防。方法对38例女童性早熟患儿详细询问病史,测身高、体质量,摄左腕正位X线片进行骨龄评价(Gmelich-Pyle法),B超检查,促性腺激素释放激素(LHRH)刺激试验:静脉注射戈那瑞林2.5μg.kg-1,分别于注射后0min、30min、60min静脉采血查血卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平。结果38例中真性性早熟18例,其中17例为原发性;假性性早熟20例,均原因不明,但对各种儿童饮料、滋补保健品经常食用及各种肉类在饮食中比例较大者假性性早熟组明显高于真性性早熟组。LHRH刺激试验LH、FSH和E2的峰值升高均明显,其中以LH峰值升高最明显。2组比较,骨龄/身高年龄差异显著,骨龄/实际年龄无统计学差异。结论LH和骨龄/身高年龄是真假性早熟最重要的鉴别指标,性早熟应以早预防、早诊断、早治疗为主,同时应对其进行心理行为干预治疗。
Objective To investigate the early identification and prevention of precocious puberty and pseudo-precocious puberty in girls. Methods 38 cases of precocious puberty were asked in detail about the history, height, body mass, Gmelich-Pyle method, B-ultrasound, gonadotropin releasing hormone (LHRH) stimulation test Intravenous gonatrelin 2.5μg.kg-1 were injected intravenously at 0, 30 and 60 minutes after injection to detect the levels of FSH, LH and E2. Results 38 cases of true precocious puberty in 18 cases, of which 17 cases of primary; pseudo-precocious puberty in 20 cases, the reasons are unknown, but a variety of children’s beverages, nourishing health products and various types of meat in the diet regularly The larger the pseudo-precocious group was significantly higher than the true precocious puberty group. LHRH stimulation test LH, FSH and E2 peak were significantly elevated, of which the most obvious increase in LH peak. There was significant difference in age of bone / height between the two groups. There was no significant difference in bone age / actual age. Conclusions LH and bone age / height and age are the most important indicators of true and false precocious puberty. Precocious puberty should be early prevention, early diagnosis and early treatment, and psychological and behavioral intervention should be taken simultaneously.