摘要目的 探讨血浆kisspeptin水平与婴幼儿女童乳房早发育(PT)的相关性.方法 选取2013年9月至2016年3月在江西省儿童医院诊治的PT婴幼儿女童(初诊年龄小于2岁)42例为研究对象,根据乳房转归情况,将其分为3组:完全消退组(CD组)18例,持续不退或退而复现组(RA组)11例,转变成特发性中枢性性早熟组(ICPP组)13例.同时选取35名年龄匹配、健康未发育女童作为对照组.采用ELISA测定血浆kisspeptin水平,同时对所有儿童进行生长发育评估、子宫卵巢彩超、基础激素测定及完善促性腺激素释放激素(GnRH)激发试验.结果 与对照组相比,CD组基础卵泡刺激素(FSH)、雌激素、催乳素水平升高,RA组身高、右侧卵巢体积、子宫体积、基础LH及FSH、雌激素、催乳素水平升高,ICPP组身高、左侧卵巢体积、子宫体积、基础LH、雌激素、催乳素水平升高;与CD组相比,RA组身高、基础LH及FSH、催乳素水平升高,ICPP组身高、左侧卵巢体积、子宫体积、基础LH及FSH、雌激素、催乳素水平升高;与RA组比较,ICPP组身高、左侧卵巢体积、基础LH及FSH水平升高(F=3.361 ～ 31.290,P均＜0.05).与对照组[(0.45±0.15) μg/L]相比,CD组[(0.46±0.06) μg/L]、RA组[(0.73±0.12) μg/L]、ICPP组[(1.52 ±0.14) μg/L] kisspeptin水平逐渐升高(F=282.8,P＜0.000 1),除CD组与对照组差异无统计学意义,其他组间差异均有统计学意义(P均＜0.05).结论 血浆kisspeptin水平与婴幼儿PT有关,kisspeptin蛋白可以作为中枢性启动的指标.

abstractsObjective To investigate the correlation between plasma kisspeptin levels and premature thelarche (PT) in female infants.Methods A total of 42 female children with PT (the age of first visit was less than 2 years old) who were diagnosed and treated in Jiangxi Children's Hospital from September,2013 to March,2016 were recruited.According to the outcome of breast changes,they were divided into 3 groups:18 in complete remission group (CD group),11 in non-remission or recurrent group (RA group),and 13 in idiopathic central precocious puberty group (ICPP group).At the same time,35 age-matched and undeveloped girls were selected as control group.Kisspeptin level was measured by ELISA.The growth and development status,ovary and uterus ultrasound,basic and gonadotropin-releasing hormone (GnRH) stimulated hormones level were checked.Results Compared with control group,the baseline follicle stimulating hormone (FSH),estrogen,and prolactin level were increased in CD group;the height,right ovary volume,uterine volume,basal luteinizing hormone (LH) and FSH values,estrogen,and lactation level were elevated in RA group;the height,left ovary volume,uterine volume,basal LH,estrogen,and prolactin were elevated in ICPP group.Compared with CD group,the height,basic LH and FSH,prolactin level in RA group were significantly upregulated,while the height,left ovary volume,uterine volume,basal LH and FSH,estrogen,and prolactin were increased in ICPP group.Compared with RA group,the height,left ovary volume,basal LH and FSH levels in ICPP group were increased(F =3.361-31.290,all P ＜ 0.05).Compared with control group [(0.45 ± 0.15) μ g/L],the level of kisspeptin was gradually increased in CD group [(0.46±0.06) μg/L],RA group [(0.73±0.12) μg/L] and ICPP group [(1.52±0.14) μg/L,F =282.8,P ＜ 0.000 1].Except the difference between CD group and control group was not statistically significant,the differences between other groups were statistically significant (all P ＜ 0.05).Conclusion Plasma kisspeptin level is related to PT of infants,and kisspeptin protein can serve as an indicator of central gonadal development.