Abstract: Obiective To explore the causes of infants with premature thelarche(PT). Methods A total of 351 infants (3 months~3 years old) with PT, an average age of 1.4 years old, from the endorctinology department of Zhengzhou Children's Hospital, were included into the oberserved groups.130 cases, an average age of 1.3 years old (3 months to 3 years old), from the in-patient department of Zhengzhou Children's Hospital, were included into the control groups.All cases were accepted the questionnaire survey and sex hormones test.Cases of the oberserved groups were followed up more than 2 years. Results 1)Breast development regressed in 296 cases of the oberserved groups within 1 year.The rate of regression was 96.7%.2)The level of estradiol in the oberserved groups was higher than the control groups, especially in the groups of 6 months ~1 year old and 1~3 years old(P<0.05).3)There were no significant differences between oberserved groups and control groups in birth weight, taking progesterone and pesticides exposure during mother pregnancy.While there were significant differences between oberserved groups and control groups in artificial feeding, using whitening skin care products of guardians and living at suburban district of Zhengzhou (P<0.05). Conclusions Maybe the major cause of infants with PT is highly sensitive of exogenous estrogen hormones or environmental pollutants base on the genetic susceptibility.A few infants with breast development have organic diseases should be follow-up for a long terms.

Key words: precocious puberty, premature thelarche, mini-puberty, environmental disruption

摘要： 目的 研究婴幼儿乳房早发育的病因, 为预防婴幼儿乳房过早发育提供参考依据。方法 2010年8-10月份就诊于郑州市儿童医院内分泌科的单纯乳房发育患儿351例女童为观察组, 平均年龄1.4岁(3月~3岁)。同期无乳房发育的住院患儿130例为对照组, 平均年龄1.3岁(3月~3岁)。所有病例均行调查问卷、检测性激素5项。观察组随访2年以上。结果 1)351例女童中, 完成随访306例(87.1%), 1年内乳房消退296例(96.7%)。2)雌二醇水平观察组高于对照组, 其中6月~1岁组、1~3岁组差异有统计学意义(P<0.05)。3)出生体重、母孕期服用孕激素史、母孕期农药接触史两组比较差异无统计学意义;观察组人工喂养率、监护人使用美白护肤品情况、来自郑州城乡结合部远高于对照组, 差异有统计学意义(P<0.05)。结论 遗传易感基础上对外源性雌激素或类激素的环境污染物高度敏感可能是婴幼儿乳房增大的主要原因。对极少数为器质性疾病引起的患儿宜长期随访。

关键词: 性早熟, 乳房早发育, 小青春期, 环境干扰物