The Prognostic Effect Of Different Initial Treatment Age On The Patients With 21-hydroxylase Deficiency

ObjectiveReviewing the clinical data of children with 21-hydroxylase deficiency,and then exploring the influence of different initial treatment time on the adult height and precocious puberty in patients with 21-hydroxylase deficiency.MethodPatients with 21-hydroxylase deficiency admitted from the First Affiliated Hospital of Zhengzhou University from September of 2015 to December 0f 2017were reviewed.The setting standard had three items,including(1)Patients could treat regularly,and visit the outpatient on a regular basis;(2)The affected children had relatively complete data;(3)Recording the following-up data that the bone age of male was 16~16.5 years of age,the bone age of female was 14~14.5 years of age,which was as the analysis node.A total of 41 cases with 21-hydroxylase deficiency were conforming to the criteria.Fourty-one patients were divided into 2 groups,under 2years old subgroup and above 2 years old subgroup,by their initial treatment age.Observe the difference between bone age and height age,the cases of central precocious puberty between two groups on last time visit,the difference about the cases of central precocious puberty between male and female subgroup.Result41 cases in children with 21-hydroxylase deficiency,18 cases(43.9%)were salt wasting,23 cases(56.1%)were simple virilizing;22 cases(53.7%)were male,and 19cases(46.3%)were female;17 cases(41.4%)were under 2 years old at their initial treatment age,24 cases(58.5%)were above 2 years old at their initial treatment age;12 cases(29.3%)were with central precocious puberty,9 cases(22.0%)were male,3cases(7.3%)were female.The difference of bone age and height age was significantly different between under 2 years old subgroup(n=17,3.26±0.35 yr)and above 2 years old subgroup(n=24,4.18±0.32 yr),t=8.81,P<0.05.The incidence rate of central precious puberty in above 2 years old subgroup(n=10,24.4%)was higher than under 2 years old subgroup(n=2,4.9%),?~2=15.059,P<0.05.The incidence rate of central precious puberty was no difference in male subgroup(n=9,22.0%)and female subgroup(n=3,7.3%),?~2=3.107,P=0.078>0.05.ConclusionThe early age for initial treatment is obviously better than the later for the finial height.The early age for initial treatment has a lower incidence of central precocious puberty.There is no difference in gender for patients with central precocious puberty.