| Background and objective: Aplastic anemia is one of severe hematopoietic system diseases,and it is still regarded as a challenge by the medical profession. Many Researches show that the immunomodulator disorder play an important role in the pathogenesis of aplastic anemia,and sex hormones (mainly including androgen and estrogen) has multiple roles for the immune system, suggesting that sex hormones may affect the incidence of aplastic anemia. Androgen has been used in aplastic anemia treatment for 40 years ,and is still the major drug for chronic aplastic anemia. In current, the mechamism of androgen stimulation hematopoietic in addition to promoting blood hematopoietic cytokine release and direct role in the promotion of hematopoietic stem cells, the level of androgen receptor also play its role in promoting blood, and androgen is also involved in immune regulation. Previously it is emphasized that large dose of androgen is used for the theary of aplastic anemia.There are certain differences between the growth and development of children and adult,and to consider there is masculine performance and side effects in the treatment of androgen, such as liver damage, so it should be formulated individualized treatment plan based on the specific children, critically including the choice of drug and suitable dosage. So we observe the changes in the levels of estradiol and testosterone in chindren with aplastic anemia, and hope this study may contribute to the diagnosis, evaluation of disease and the efficacy and prognosis.Methods: We selected 47 cases of early childhood aplastic anemia patients, 24 male and 23 female.There are 28 cases with acute aplastic anemia and 19 cases with chronic aplastic anemia. At the same time we choose 26 cases of normal children as a control group. All confirmed cases of aplastic anemia were given cyclosporine A and androgen for therapy conventionally,of which 28 cases were followed up twelve months.Radioimmunoassay was used to detect the levels of estrogen and testosterone in these 47 patients and normal children. And at the same time we stimulate the determination of its blood,the reticulocyte count, immunoglobulin levels, liver function, renal function and so on. Results:Compared with normal children,the testosterone level and T/E2 was significantly decreased(P<0.05) in children with aplastic anemia. there was no significant correlation between testosterone and anemia degree( P>0.05);Chronic aplastic anemia group, The level of serum estradiol in newly diagnosed aplastic anemia is significally higher than that in the normal control group,while there was no significant difference between acute aplastic anemia and normal children ( P>0.05);The testosterone level after treatment in effective groups is higher than that of before treatment (P < 0.05),while the testosterone level in ineffective group had no significant difference compared to that of before tretment( P>0. 05); In effective group the ineffective group with aplastic anemia ,there was no significant difference in the estradiol level between the treated group and untreated group(P>0. 05). There was no signifieant difference in the content of IgA,IgG,IgM between treated and untreated children with aplastic anemia (P>0.05). The levels of estradiol and testosterone in chindren with aplastic anemia have no correlation with the content of IgA,IgG,IgM. Conclusions: There are disorders and imbalance of sexual hormone metabolism in children with aplastic anemia. Estradiol levels increase in chronic aplastic anemia, but have no significant changes in acute aplastic anemia.There is no obvious humoral immune dysfunction in children with aplastic anemia before therapy, and the reduced levels of androgen does not mainly affect the humoral immune function. The detection of the levels of serum testosterone and estradiol may be helpful for predicting the effect of thearpy and thearpy of aplastic anemia,and for the early diagnosis and differential diagnosis.
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