环境内分泌干扰物与儿童性早熟发病的关系

The relationship of the environment endocrine disruptors with precocious puberty

目的:探讨环境内分泌干扰物(EEDs)与儿童性早熟发病的关系。方法:收集2005年3月至2005年9月在性早熟专科门诊就诊的初诊患儿110例及正常儿童100例。采用高效液相色谱及气相色谱分析法测定性早熟患儿及正常儿童血清中辛基酚(OP)、双酚A(BPA)和邻苯二甲酸二丁酯(DBP)的含量。同时测定患儿的子宫、卵巢体积和血清雌二醇(E2)含量。将血清EEDs含量与靶器官发育的指标作相关性分析。结果:正常儿童中,5.0%血清检测到OP(中位数,下同)为2.72ng/ml,2.0%检测到BPA(2.11ng/ml),4.0%检测到DBP(0.52ng/ml);性早熟患儿中,33.6%血清检测到OP(7.38ng/ml),40.9%检测到BPA(9.15ng/ml),27.3%检测到DBP(2.76ng/ml)。性早熟患儿血清中EEDs含量显著高于正常儿童(P<0.001)。患儿血清OP、BPA、DBP含量与其子宫体积均呈显著正相关(P<0.05或0.01),血清OP、DBP含量与其卵巢体积均呈显著正相关(P<0.05或0.01)。结论:当前的正常儿童已有一部分暴露于EEDs,性早熟患儿EEDs的暴露程度比正常儿童严重得多。EEDs与性早熟的发病密切相关,是其重要的致病因素之一。

Objective： To explore the relationship of the environmental endocrine disruptors（EEDs） with the onset ofprecocious puberty. Method： The blood samples were collected from 110 cases of precocious puberty and 100 cases of normal children who initially visited the precocious puberty outpatient department from March to Sept. 2005. The concentrations of octylphenol （OP）, bisphenol A （BPA） and di-n-butyl phthalate （DBP） in the serum were measured with high performance liquid chromatography（HPLC） and gas chromatography. The volume of uterus and ovary, and the content of estradiol （E2） in the serum of precocious puberty were determined at the same time. The contents of EEDs in the serums and the indices of the target organs were analyzed by the methods of correlation and regression. Result： In normal control group, OP, BPA, DBP were detected as [2.72 p-g/L, 2.11 μg/L, 0.52 μg/L（median, the same below）] in 5%, 2%, 4% of serum samples respectively. In precocious puberty group, OP, BPA, DBP, （ 7.38 μg/L, 9.15 μg/L, 2.76 μg/L ） in 33.6%, 40.9%, 27.3% of serum samples respectively. The levels of EEDs in the serum of the precocious puberty group were notably higher than that of the control group （P 〈 0.001）. In precocious puberty group, positive correlations were found between the contents of OP, BPA, DBP and the volume of uterus （P 〈 0.05 or 0.01）. The contents of OP, DBP and the volume of ovary also had a positive correlation （P 〈0.05or0.01）. Conclusion： At present part of the normal children has been contaminated by EEDs, and the children of precocious puberty have been much more heavily exposed to EEDs than the normal children. There is a close relationship between EEDs and the onset of precocious puberty, and EEDs are the important factors inducing the disease.