Ilicki A, Prager Lewin R, Kauli R, Kaufman H, Schachter A, Laron Z
Acta Paediatr Scand. 1984 Nov;73(6):756-62. doi: 10.1111/j.1651-2227.1984.tb17771.x.
Data obtained during long-term follow-up of 68 girls with premature thelarche were analysed. In 85% onset was before the age of 2 years, in 30.8% being present at birth. In 44.1% there was a regression after 3 2/12 +/- 2 8/12 years (SD). Basal levels of plasma FSH and response to LH-RH were significantly higher than prepubertal controls (1.93 +/- 1.56 vs. 0.8 +/- 0.1 mU/ml and peaks 12.3 +/- 5.4 vs. 7.9 +/- 1.0 mU/ml respectively; p less than 0.001). Twenty-seven of 52 patients tested had increased plasma estradiol and in 27 of 40 patients tested, urocytograms or vaginal smear showed estrogenization. Basal levels of LH and response to LH-RH were prepubertal. The girls with premature thelarche were significantly taller than normal controls of the same age (p less than 0.001). These results suggest that premature thelarche is an incomplete form of precocious sexual development probably due to derangement in the maturation of the hypothalamo-pituitary-gonadal axis which results in a higher than normal secretion of FSH, as well as a defect in the peripheral sensitivity to the sex hormones.
对68例乳房早发育女童进行长期随访所获得的数据进行了分析。85%的女童发病年龄在2岁之前，30.8%在出生时就已出现。44.1%的女童在3又2/12±2又8/12年（标准差）后出现消退。血浆促卵泡生成素（FSH）基础水平及对促黄体生成素释放激素（LH-RH）的反应显著高于青春期前对照儿童（分别为1.93±1.56 vs. 0.8±0.1 mU/ml以及峰值12.3±5.4 vs. 7.9±1.0 mU/ml；p<0.001）。52例接受检测的患者中有27例血浆雌二醇升高，40例接受检测的患者中有27例尿细胞图或阴道涂片显示有雌激素化现象。促黄体生成素（LH）基础水平及对LH-RH的反应处于青春期前水平。乳房早发育女童明显高于同龄正常对照儿童（p<0.001）。这些结果表明，乳房早发育是性早熟的一种不完全形式，可能是由于下丘脑-垂体-性腺轴成熟紊乱，导致FSH分泌高于正常水平，以及外周对性激素的敏感性存在缺陷。
