郑州地区3～12岁儿童性早熟流行病学调查

Study on Prevalence of Precocious Puberty in Children in Zhengzhou Region

目的了解郑州地区儿童性早熟发病状况,为该病的防治提供理论依据。方法采用分层整群抽样方法,抽取郑州地区12所小学的8 750例3～12岁儿童为调查对象,对受试者乳房、阴毛、睾丸等进行分期评定,月经初潮情况通过家长问卷调查和询问本人获得,同时测定其身高、体质量等指标。结果郑州地区儿童性早熟检出率为0.74%,女童发生率高于男童(1.37%vs0.26%,P=0.000)。超重女童和肥胖女童性早熟发病率高于正常体质量女童(健康对照组),差异有统计学意义(3.1%vs1.1%,P=0.001),而不同体质量男童间差异无统计学意义(P=0.111)。乳房开始发育年龄为(10.18±1.12)岁,城区女童早于郊县女童[(9.83±1.11)岁vs(10.49±1.05)岁],差异有统计学意义(t=-7.580,P=0.000)。阴毛开始发育年龄为(11.56±0.86)岁,城区女童和郊县女童比较差异无统计学意义[(11.57±0.87)岁vs(11.54±0.86)岁,P=0.820)]。性早熟组瘦素、雌二醇、卵泡刺激素及黄体生成素水平均高于健康对照组(Pa=0.0000、0.000、0.007、0.002)。结论郑州地区性早熟发生率为0.74%,其中女童发病率高,超重和肥胖是女童性早熟不可忽视的原因。城区女童青春期启动年龄早于郊区女童。

Objective To investigate the prevalence of precocious puberty in children in Zhengzhou region and provide theoretical basis for prevention and treatment of this disease.Methods Eight thousand seven hundred and fifty children from 3 to 12 years old were selected from Zhengzhou region by stratified and cluster sampling.All of them accepted physical examination,in terms of height,weight,breast,public hair,testes,etc.and told their menarche.Results The detection rates of children with precocious puberty were 0.74% in Zhengzhou region.The rates of precocious puberty in girls（1.37%） were higher than that in boys（0.26%）,and the difference was statistically significant（P=0.000）.The detection rates of precocious puberty in overweight and obesity girls（3.1%） was much higher than that of the normal girls（1.1%）（P=0.001）,while there were no significant differences in boys.Age at the onset of breast in girls was（10.18±1.13）years,it in city [（9.83±1.11） years] was earlier than that in urban [（10.18±1.12） years]（P=0.000）.Age of the public hair appearance in girls was（11.56±0.86） years,there was no significant difference between the city [（11.57±0.87） years] and the urban [（11.54±0.86） years]（P=0.820）.The levels of leptin,estrogen,follicle-stimulating hormone and luteinizing hormone in girls with precocious puberty were higher than those of the control group（Pa=0.000,0.000,0.007,0.002）.Conclusions The detection rates of children with precocious puberty are 0.74% in Zhengzhou region,and the incidence in girls is higher than that of boys.Overweight and obesity are the important reasons to result in precocious puberty in girls.Age of the onset puberty in girls in city comes earlier than that in urban area.