【摘要】 目的 为了掌握我国沿海地区小儿性早熟的发病情况，进行可靠的临床筛查，调查小儿性早熟的流行病学并进行相关分析，为我国提供该方面的第一手资料。方法 分为初步筛查，临床检测及相关分析3个阶段。检测性早熟儿内分泌ESH、LH、E2等激素并做GHRH试验，对早熟儿进行韦氏量表打分，分析早熟儿与正常儿的智商差异。对女性早熟儿行B超测子宫及卵巢，并与正常同龄儿对照。探讨当地小儿性早熟的流行病学，进行相关分析。结果 (1)通过对本地区22281人次的筛查，查出阳性病例84例。其中，男9例(特发性性早熟7例、部分性性早熟2例)，女75例(特发性性早熟30例、假性性早熟8例、部分性性早熟37例)。(2)女性特发性早熟儿子宫、卵巢B超值及内分泌FSH、LH、E2等激素检测值大于正常同龄儿(P<0.05)，而假性及部分性性早熟基本正常。(3)早熟儿智商略低于正常儿，但差异不明显，其原因有待进一步研究。(4)生活在城镇、经济发达、污染严重地区，母亲初潮早，社会因素，营养状况，服用滋补药，遗传等诸多因素对性早熟起作用。结论 沿海地区小儿性早熟的发病率为0.38%，女性性早熟发病率较高(0.67%)，与国内外有关资料接近。B超检测子宫、卵巢及内分泌FSH、LH、E2等激素检测是临床女性特发性早熟筛查简易、可靠的方法。了解其多影响因素并进行干预，可降低其发病率。

    关键词 性早熟 子宫 卵巢 性激素 B超 流行病学

    Investigation and research on precocious puberty in the easterncoast in Zhejiang province

    Lin Feng,Zheng Changhua,Li Hua,et al.

    The Affiliated WenLing Hospital of Wenzhou Medical College,Zhejiang 317500.

    【Abstract】 Objective To explore the morbility of children's precocious puberty in the Eastern Coast in China,to take reliably clinical screening,to investigate the epidemiology of children's precocious puberty and analyze their correlation,and to give firsthand data about this.Methods This study included 3 stages:preliminary screening,clinical detection and correlation analysis.We detecfed the level of FSH,LH and E2 of the children with precocious puberty and made the GHRH test,scored the children according to Wenz's scale,and analyzed the difference of intelligence quotient between the children with precocious puberty and the normal children.Whereas we detected their uterus and ovary with ultrasonic detector and compared them with normal children.We evaluated the epedemiology of the children's precocions puberty in these areas,and made correlation analysis.Results (1)of 22281 person-times screened,there were 84 positive cases including 9 male cases (idiopathic precocious puberty (IPP) was 7 cases and Partial precocious puberty(PPP) 2 cases),and 75 female cases(IPP 30 cases,pseudo precocious pubety 8 cases,and PPP 37 cases).(2)There were significant differences between the female with IPP and the normal children in the size of uterus and ovary with ultrasound,and the level of FSH,LH and E2(P<0.05),whereas they were almost normal for the children with PPP and pseudo precocious puberty.(3)Intelligence quotient of the children with precocious puberty was slightly lower than that of the normal children.It was possibly related to precocious puberty,but there was significant difference,Further research is necessary.(4)That were important roles to live in city,developed and polluted areas,for their mothers to have early first mcnses,and to have certain social enviorment,excessive nutrition,certain heredity factor,and take nourishing food and so on.Conclusion The morbility of the children's precocious puberty in the Eastern coast in Zhejiang province is 0.38%.There is higher morbility for the female(0.67%),which is similar to other reports.They are simple and reliable to detect uterus and ovary with ultrasound and test the levels of FSH,LH and E2 for screening female IPP.There is not definite pathogeny,but it can lower the morbility to know multiple influential factors and intervene. ......