吴玉筠 首都医科大学附属北京儿童医院内科主任医师

WuYuJun capital medical university affiliated Beijing children's hospital medical chief physician

　　万乃君 首都儿科研究所附属儿童医院内分泌科副主任医师

All the capital is king of pediatric research institute affiliated children's hospital of doctor of vice director of endocrinology

光照过度易导致性早熟 Light too easy to precocious puberty

“女孩四岁性早熟，床头小夜灯是真凶。” "At the age of four girls precocious puberty,The head of a bed small night light is a murderer."

　　对于小夜灯是否真的能导致孩子性早熟，首都医科大学附属北京儿童医院内科主任医师吴玉筠说，光照过度也是儿童性早熟的重要原因之一，这是由人体内松果体分泌的褪黑激素引起的。褪黑激素能抑制腺垂体促性腺激素的释放，可以防止性早熟。当人在夜间进入睡眠状态时，松果体会分泌大量的褪黑激素，天亮时便停止分泌。人类的松果体一般在儿童中期发育至高峰，抑制性腺的过早发育，从7—10岁起，松果体开始逐渐退化，性机能随之慢慢增强。儿童若受过多的光线照射，就会减少松果体褪黑激素的分泌，导致性早熟。

For small night light really can cause children precocious puberty,The capital medical university affiliated Beijing children's hospital medical chief physician WuYuJun said,Excessive light is one of the important reasons for discovered early,It is up to the human body the pineal gland secretion of melatonin cause.Melatonin can restrain adenohypophysis gonadotropin release,Can prevent precocious puberty.When the person when entering morpheus state in the night,Pine cones experience secretion lots of melatonin,At daybreak he stopped secretion.Human pineal gland in general middle child development to peak,Inhibition of gonadal early development,From the age of 10 -,The pineal gland begin to degenerate,Sexual function then slowly increase.If the children too much light,Will reduce the pineal gland secretion of melatonin,Cause precocious puberty.

　　吴玉筠说，导致性早熟的这种过度光照，既可来自阳光，也可来自灯光，非自然光的作用更大，如长时间的电视、电脑显示屏光照射，也可能导致儿童性早熟。

WuYuJun said,Lead to precocious puberty this too light,Not only can come from the sun,Also can come from light,The role of natural light is not more,As a long time of TV/The computer screen light irradiation,May also cause discovered early.

男孩性早熟更需要重视 The boy precocious puberty need more attention

　　首都儿科研究所附属儿童医院内分泌科副主任医师万乃君介绍，医学上界定的性早熟主要跟年龄有关系，如果在一个固定年龄段之前出现第二性征的发育，就应注意性早熟，如女孩在8岁以前出现第二性征发育，最常见到的是乳腺发育；女孩在10岁以前出现月经来潮，都要考虑性早熟。男孩比女孩的青春期发育相对晚一些，所以，男孩9岁以前出现第二性征发育，如睾丸变大，阴茎变粗，长阴毛等，也要考虑性早熟。

The capital pediatric research institute affiliated children's hospital endocrinology of doctor of vice director of all is the gentleman is introduced,Medical definition of precocious puberty mainly with age have a relationship,If in a fixed age appear before the development of secondary sex characteristics,You should pay attention to precocious puberty,If the girl in eight years ago appear secondary sexual character development,The most common is mammary gland development;The girl in the ten years ago appear menstrual cramps,Will consider precocious puberty.Boys are better than girls' puberty relatively late,so,The boy appear until 9 years old secondary sex characteristics growth,Such as testicular bigger,Penis coarsens,Long pubic hair, etc,Also want to consider precocious puberty.

　　需要注意的是，女孩性早熟，往往是特发性的，原因不明，多数不存在器质性病变。而男孩性早熟，有一半可能存在器质性病变，要注意垂体的肿瘤、性腺的肿瘤或者一些其他分泌性激素的肿瘤，所以，男孩出现性早熟，家长一定要重视，及时就诊。

Need to pay attention to is,Girls precocious puberty,Often is the essential,Reason unknown,Most don't organic lesion is present.While the boys precocious puberty,Half may organic lesion is present,Attention should be paid to pituitary tumor/Gland cancer or some other hormones secretion of tumor,so,The boy appeared precocious puberty,Parents must attach importance to,Prompt medical attention.

　　首都医科大学附属北京儿童医院内科主任医师吴玉筠介绍，性早熟分中枢性和外周性两种。中枢性性早熟，也是真性性早熟，绝大部分是特发性，是指目前的检查手段无法找到具体的原因。外周性性早熟，一般是有原因的，通过抑制或消除其原因，就可以将性早熟停止并回缩。不过，外周性性早熟如果时间长了，也完全可能进展为中枢性性早熟。

The capital medical university affiliated Beijing children's hospital medical chief physician WuYuJun is introduced,Precocious puberty points central and peripheral two.Central precocious puberty,Is also true precocious puberty,The majority is essential,Refers to the current inspection method cannot find specific reason.Peripheral precocious puberty,The general is a reason,Through the inhibition or eliminate its reason,Can the precocious puberty stop and rebound.but,Peripheral precocious puberty if time long,Also fully may progress for central precocious puberty.

性发育提前是趋势 Sexual development advance is a trend

　　从门诊的情况来看，男孩性早熟，非常少，与女孩相比，是五比一，甚至达九比一。

From the clinic situation,The boy precocious puberty,Very little,Compared with the girl,Is five to one,Even more than a nine.

　　万乃君说，目前来就诊性早熟的绝大多数是女孩；如果一个男孩出现性早熟，我们就特别重视，一定要全面检查，尽可能明确病因。近一百年的研究表明，每十年，性发育的年龄会提前两三个月，这是一个大趋势。因为从营养状态、生活环境等方面的变化，都会促进性发育提前。所以，家长不能用自己的经验来判断孩子是否性早熟，比如家长自己是十三四岁来月经，而现在的孩子十一二岁来月经很常见，不能说这就是性早熟。

All is king,At present a precocious puberty to most is a girl;If a boy appeared precocious puberty,We will pay special attention to,Must be comprehensive inspection,Identify as clearly as you can cause.Nearly one hundred years of study,Every ten years,Sexual development age will advance two or three months,This is a big trend.Because from nutritional status/The change of living environment, etc,Will promote sexual development in advance.so,Parents can't use their experience to determine whether children precocious puberty,Such as parents he is 13 or 14 to menstruation,Now the child his preteens to menstruation is very common,Can't say this is precocious puberty.

热点问答 Hot question

明显生长加速可怀疑性早熟 Obvious growth acceleration can be skeptical early

Q性早熟需要进行哪些检查？ Q precocious puberty what should check?

　　万乃君：如果孩子年龄较小，就出现第二性征发育的现象，应怀疑是否存在性早熟，还要看是否伴随生长加速的现象。真性性早熟的孩子，会有明显的生长加速，家长需要注意，孩子是不是最近一段时间，如这半年或近几个月，长得特别快，明显地看到孩子长高了，这是一个应引起注意的现象。

All prince is:If a child younger,Appear the phenomenon of secondary sex characteristics growth,If there should be suspected precocious puberty,Will see if with growth accelerated phenomenon.True precocious puberty children,There will be obvious growth acceleration,Parents need to pay attention to,The child is a recent period of time,Such as the half a year or in recent months,Long so quickly,Clearly see the child has grown,This is a phenomenon should be attention.

　　此外，还要做一些相关激素的检查，如有必要，还要做药物的激发试验，因为有些孩子可能基础性激素水平没有明显升高，但在药物激发以后，可以看到激素水平的明显变化。

In addition,Still need to do some related hormone inspection,If necessary,Still need to do drug excitation test,For some children may base sex hormones levels were significantly higher,But in drug excitation later,Can see the hormone level changes obviously.

　　再有一些就是影像学的检查，如骨龄照片，包括乳腺、盆腔B超，看女孩子宫卵巢的发育情况，来综合判断这个孩子是不是真正的性早熟。

Have some is radiographic inspection,Such as bone age photos,Include breast/Pelvic B ultrasonic,Look at the girl uterine ovarian development situation,The comprehensive judgment to the child not really the precocious puberty.

性早熟主要对心理和身高 Precocious puberty mainly to the psychological and height

Q性早熟有哪些危害？ Q precocious puberty what harm?

　　吴玉筠：一是心理方面。因为孩子较小，尤其是上学后，周边都是小朋友，一旦她的乳房开始发育，会觉得自己跟别人不一样，其他孩子也可能会有不当言论，给孩子造成很大的心理负担。二是对身高的影响。真正性早熟的孩子都有骨龄提前的情况，一般会提前两三年，这样，他相对生长的时间就变短了，将来身高就会比别人矮，如不及时处理，将来是没法补救的。

WuYuJun:One is the psychological aspects.Because the child is,Especially after school,Peripheral are children,Once her breasts started to development,Feel different with others,Other children may also be improper remarks,Give children caused great psychological burden.The second is to the influence of the height.True precocious puberty children have bone age of early,Usually two or three years in advance,this,He relative growth time is shortened,The future height will be shorter than others,If not handled in a timely manner,The future is can't remedial.

　　最后是安全性问题。八九岁的孩子如果来月经，就有怀孕的风险，存在很大的安全隐患。

The security problem.Eight or nine years old children if period,There is the risk of pregnancy,There is a big potential safety problems.

性征可回缩骨龄不可逆 Sexuality can rebound bone age irreversible

Q性早熟通过治疗，是否是可逆的？ Q precocious puberty through treatment,Is reversible?

　　万乃君：看其程度，如果是外周性的，单单出现了乳房发育，家长发现比较早，比如一两个星期，发现了就来看病，没有明显的生长加速，骨龄也不超前，激素水平也没有明显的升高，往往可能存在一定的诱因，只要把诱因去除，乳腺就会逐渐回缩，恢复到正常水平。对外周性性早熟的孩子，进行干预好转后，对将来一般是不会有较大影响的。

All prince is:See its degree,If the peripheral,Only appeared mammary development,Parents found earlier,Such as a week or two,Found to see a doctor,No obvious growth acceleration,Bone age don't advance,Hormone level also no obvious rise,Often there may be some incentive,As long as the incentive to remove,Mammary gland will gradually rebound,Back to the normal level.Foreign weeks sexual precocious child,Intervention after improved,In the future it is commonly won't have greater influence.

　　但骨龄超前出现了是不可逆转的，比如八岁的孩子，骨龄十岁，治疗后，骨龄也不可能退回到八岁，因此身高就可能丢失，毕竟他少了两年的生长时间。原来基础身高就矮，骨龄又超前，属于又矮又早发育，这是最麻烦的。

But the bone age advance appeared is irreversible,Such as eight years old,Bone age ten years old,After treatment,Bone age is not likely to return to eight years old,Therefore height may be lost,After all, he less two years of growth time.The original foundation height is short,Bone age and advance,Belong to and short and early development,This is the most troublesome.

原因分析 Cause analysis

饮食 洋快餐、补品都可引起性早熟 Diet favored/Supplements can cause precocious puberty

　　首都儿研所内分泌科副主任医师万乃君介绍，外周性性早熟，临床上看到比较多的原因，往往跟饮食有关系，这是比较常见的。比如喜欢吃肉鸡的鸡肉，尤其是洋快餐吃的比较多的，还有一些吃补品的孩子，包括吃蛋白粉，都能够看到性早熟的案例。

The capital ErYanSuo endocrinology of doctor of vice director of all is the gentleman is introduced,Peripheral precocious puberty,Clinical see more reasons,Often there is a connection between with diet,This is more common.Such as like to eat chicken chicken,Especially favored to eat more,There are some children eat tonic,Including eat protein powder,To be able to see the precocious puberty case.

　　有个案例，家长是朝鲜族人，每天做豆芽汤，孩子很爱吃，孩子2岁多时出现乳腺发育。经过检查，诊断为外周性的性早熟，通过排查，觉得可能跟豆芽汤有关，就停止吃了，不到一个星期，孩子乳腺就回缩了。

There is a case,Parents is north Korea's race,Every day do bean soup,Children love to eat,As children 2 years old in mammary gland development.After inspection,Diagnosis of peripheral precocious puberty,Through the traffic,Think it with the bean soup,Stop eating the,Less than a week,Children will rebound the mammary gland.

【饮食TIPS】 [Diet TIPS]

　　一般来说，出现性早熟的孩子，鸡、鸭等家禽类最好不吃，蜂蜜、蜂王浆，黄芪、人参，还有燕窝，这些补品也最好不要吃，还有初乳，现在儿科都不让再用了，以前有吃初乳素后出现性早熟的案例。

Generally speaking,Precocious puberty in children,chicken/, ducks and other poultry had better not eat,honey/Royal jelly,Astragalus membranaceus/ginseng,There are bird's nest,These supplements also had better not eat,And colostrum,Now pediatric all don't let in again,Used to have to eat ChuRuSu appears after the precocious puberty case.

　　包括一些豆制品，含有植物雌激素的这类东西，如豆浆，如果出现乳腺发育也不要吃了。还有反季节的水果蔬菜，不建议吃。另外，塑料奶瓶，也不建议家长用，最好全换成玻璃的。

Including some bean products,Contains phytoestrogens this kind of things,Such as soybean milk,If appear mammary gland development also don't eat.And out of season of fruit and vegetables,Do not recommend eating.In addition,Plastic bottles,Don't advise parents to use,All the best for the glass.

化妆品 成人化妆品缺乏激素检测 Cosmetics adult cosmetic lack of hormone detection

　　首都儿研所内分泌科副主任医师万乃君说，化妆品的问题要特别提醒，以前有妈妈用丰乳霜，孩子拿空瓶子玩，乳腺发育了，因为丰乳霜就是通过皮肤吸收的，或者妈妈使用后，抱孩子，或喂奶，都会导致孩子出现乳腺发育，这个问题现在比较少，家长都比较注意了。

The capital ErYanSuo endocrinology of doctor of vice director of all is the king,Cosmetics to special remind,Mother used to have with abundant breast cream,Children take empty bottle to play,Mammary gland development the,Because of abundant breast cream is absorbed through the skin,Or mother after use,Holding the baby,Or nursing,Will lead to the child of breast development,The question now is less,Parents are more attention.

　　万乃君说，就在最近，看到一个病人，家长带着孩子一起去国外玩，家长买了很多护手霜、擦手油，想回国后送人，因为包装很好看，孩子很喜欢，就老拿着玩。妈妈也是在国外就开始涂，但回国后，孩子就乳腺发育了，因为平时家长对孩子的饮食等方面挺在意的，经排查，觉得可能跟这些化妆品有关，不使用一两个星期后回来复查，孩子的乳腺就回缩了。

All is king,In recent,See a patient,Parents take their children to go abroad to play,Parents bought a lot of hand cream/Hand rub oil,Want to send people back,Because the packing looks very nice,Children like,It took the old play.Mom is in abroad began to coat,But after returning home,The child is the mammary gland development,Because at ordinary times the parent to the child's diet's care,The traffic,Think it with the relevant cosmetics,Do not use after a week or two back to review,The child's mammary gland is a retraction.

　　万乃君说，很多性早熟的原因，只能反过来推，很可能是跟这个有关系，但目前医院没有做这方面的检测能力，比如检测化妆品中是否含有过量雌激素等。

All is king,A lot of precocious puberty reason,Can in turn push,Is likely to be with this relationship,But at present the hospital didn't do the detection ability,Such as detection in the cosmetics, such as whether it contains excessive estrogen.

误区释疑 Error disabuse

小鸡鸡“晨起” 憋尿导致小鸡鸡变硬 Chicken chicken"Since morning" Suppress urine lead to chicken chicken harden

　　爸爸赵宁：早上起来，发现5岁儿子的小鸡鸡是直的，这是勃起吗，是否属于性早熟？

Dad ZhaoNing:The morning,Find five year old son chicken chicken is straight,This is a erectile,Whether to belong to precocious puberty?

　　吴玉筠：如果没有睾丸增大等性器官发育，应该不属于性早熟。可能是早上起来，孩子有尿，憋尿才导致小鸡鸡变硬了。小男孩尿尿的时候，小鸡鸡都是要变硬的，否则就尿不远。所以，早上起来，小男孩有尿的时候，小鸡鸡就是立着的，这是很常见的。

WuYuJun:If there is no increase in testicular organ development,Should not belong to precocious puberty.May be in the morning,Children have urine,Suppress urine can cause the chicken chicken harden.The little boy when pee,Chicken chicken is hard to change,Otherwise not far from urine.so,The morning,The little boy has the urine,Chicken chicken is made of,This is very common.

　　出现乳沟 B超可确诊是否过早发育

Appear cleavage B ultrasonic can diagnose whether early development

　　爸爸杨建：给3岁的女儿洗澡，发现她趴在澡盆边上时都有乳沟了，这是乳房发育吗？

Dad England:3 year old daughter to take a shower,Find her over the edge tub when have the cleavage,This is mammary development?

　　吴玉筠：这个年龄段的小女孩出现乳沟是不太可能的，即使是乳腺开始发育了，最多也是个二期，不会出现乳沟。可能是胖的缘故，有些小孩，甚至是男孩子，由于太胖，胸部就显得很大，就像是成年女性的乳房，但通过B超可以看到，里面什么都没有，就是脂肪堆积。

WuYuJun:This age paragraph the little girl appear cleavage is unlikely,Even if is mammary gland began the development,The most is a two stage,Won't appear cleavage.May be because of fat,Some children,Even boys,As a result of too fat,The chest is big,Like adult female breast,But through the B ultrasonic can see,There's nothing there,Is adipose accumulation.

　　家长如果看到孩子乳腺区增大，可以摸一下，看里面有没有乳核，如果不放心，可以到医院做一个B超，看有没有乳腺组织。（采写/新京报记者 林文龙）

If you see parents children breast area increases,Can touch the,See inside have milk nuclear,If not be at ease,Can go to a hospital doing B to exceed a,Look have breast tissue.(Article/Beijing news reporter LinWenLong)