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目的了解不同初治年龄对先天性肾上腺皮质增生症(CAH)患儿身高、骨龄、性早熟等方面的影响。方法将1982～2004年在上海新华医院和上海市儿科医学研究所内分泌、遗传代谢病专科诊治的32例CAH患儿(年龄:女≥8岁,男≥9岁),按初治年龄分为≤3岁组(14例)和>3岁组(18例),观察两组间末次复诊时骨龄与身高龄之差、性早熟例数及男女患儿发生性早熟的不同。结果14例初治年龄≤3岁患儿末次复诊时骨龄与身高龄之差(3.0±2.0)岁]与18例>3岁组(4.6±1.6)岁]比较差异有显著性(P<0.05),初治年龄>3岁组发生真性性早熟(9例)与≤3岁组(2例)比较差异有显著性(χ2=4.453,P<0.05)。男性患儿发生真性性早熟(9例)与女性患儿(2例)比较差异有显著性(χ2=4.794,P<0.05)。结论CAH患儿≤3岁得到诊治者其预测终身高较>3岁方诊治者明显改善,其性早熟发生率明显减少,男性CAH患儿较女性CAH患儿更易发生性早熟。

Different effect of initial treatment age on congenital adrenal hyperplasia patients

?? AbstractObjectiveTo observe the influence of the initial treatment time on the height,bone age and precocious puberty in patients with congenital adrenal hyperplasia. MethodsThirty??two patients with CAH were divided into 2 groups from 1982 to 2004,under 3 years old and above 3 years old subgroup,by their initial treatment age.Observe the difference about bone age,the height age and the cases of precocious puberty between two groups on last time visit and the difference about the cases of precocious puberty between male and female subgroup. ResultsThe difference of bone age and height age was significantly different between under 3 years old subgroup (n=14,3??0??2??0 yr) and above 3 years old subgroup (n=18,4??6??1??6 yr),P<0??05.The incidence rate of central precocious puberty in above 3 years old subgroup (n=9,50%) was higher than under 3 years old subgroup (n=2,14??3%) (??2=4??453??P<0??05).The incidence of central precocious puberty in male subgroup (n=9,69??2%) was found to be higher than female subgroup (??2=4??794??P<0??05). ConclusionThe prediction of final height in patients with CAH can be more obviously improved in the initial treatment age under 3 years old group than above 3 years old group;the early treatment can also decrease the incidence rate of central precocious puberty.The incidence of central precocious puberty is higher in boy than in girls.