小于2岁婴幼儿乳房早发育临床随访研究

A clinical follow-up study of premature thelarche in infants under two years of age

摘要:

目的：了解小于2岁婴幼儿乳房发育的临床现况及转归，分析影响乳房消退的相关因素。方法：分析2009年10月至2010年9月间因乳房早发育来我院内分泌科就诊的863例2岁以下患儿临床及实验诊断资料并进行纵向随访研究。结果：小于2岁单纯乳房早发育患儿中绝大多数（89.3%）在3周岁内消退，乳房消退平均年龄为17±6月龄；小部分（10.7%）反复或持续增大，3岁后仍不消退，极少数转变为中枢性性早熟。初诊时乳房Tanner分期和基础E2值升高与否是影响乳房消退的独立危险因素。结论：小于2岁婴幼儿乳房早发育在临床并不少见，大多呈自限性病程，3周岁内可消退，但对2岁以上乳房增大持续不消退者要定期随访。

Abstract:

OBJECTIVE: To investigate the clinical status and natural course of premature thelarche (PT) in infants under 2 years of age and to analyze the predictive factors for regression of thelarche. METHODS: The clinical and laboratory data of 863 infants under 2 years of age, who visited the department of endocrinology in our hospital due to PT between October 2009 and September 2010, were analyzed. A a longitudinal follow-up study was performed. RESULTS: Of the infants under 2 years of age with isolated PT, 89.3% showed a regression before the age of 3 years (mean 17±5.6 months), 10.7% had recurrent or persistent thelarche, with no regression after the age of 3 years, and some even developed into central precocious puberty. The independent predictive factors for regression of thelarche were Tanner stage at the first visit and whether baseline estradiol level had increased. CONCLUSIONS: PT in infants under 2 years of age is not rare in the clinical setting, and it usually runs a self-limited course, subsiding before the age of 3 years. However, regular follow-ups should be performed for infants aged over 2 years with persistent thelarche.