郑州地区6～13岁男童性发育现状调查

Status survey of sexual development of boys aged 6 to 13 years old from Zhengzhou area

目的：男童性发育不仅受年龄因素影响，且与所处环境、地区等因素有关。文中调查及评价郑州地区男童的性发育现状并探讨其影响因素。方法对来自郑州地区3779名6～13岁男童的身高、体重、腰围、臀围、阴茎及睾丸进行测定，比较不同年龄阴茎长度及睾丸容积的变化及影响因素，以及性发育的首发年龄及其特征。依据Tanner分期标准及标准图谱对受试者外生殖器和阴毛的发育情况进行分期评定，均分为5期。结果睾丸容积、阴茎长度随年龄增加而增大，在6～11岁时增加缓慢，11岁后迅速增加。睾丸容积增加幅度大于阴茎长度。3779名男童中超重395名（10．45％），肥胖208名（5．50％），正常组、超重组、肥胖组睾丸体积的平均秩次分别为1760．47、2036．20、1889．86，经秩和检验，3组间比较有显著差异（H＝27．01，P＝0．00），正常组与超重组睾丸体积比较有差异，超重组睾丸体积大于正常组（P＝0．00）；正常组、超重组与肥胖组睾丸体积比较均无差异（P＝0．08，P ＝0．10）；超重组、肥胖组的阴茎长度均明显小于正常组（P＜0．01），超重组与肥胖组阴茎长度比较无差异。睾丸容积、阴茎长度均与年龄、身高、体重、 BMI、腰围、臀围呈正相关，其中睾丸容积与身高相关性最强，而阴茎长度与年龄相关性最强。城区男童睾丸开始发育的年龄（平均12．02岁）晚于郊县（平均9．90岁）2．73岁，差异有统计学意义（P＜0．01）；阴毛开始发育（P2）和成熟（P5）的平均年龄分别为（12．34±0．83）岁和（12．39±1．24）岁。男童性早熟发生率为0．40％。结论郑州地区男童的性发育趋势与中国大规模调查结果接近，但对于肥胖对性发育的影响应引起相关部门的高度重视，尽早干预，避免性发育不良事件的发生。

Objective Boy sexual development is affected not only by age, but also by environment factors .The present study was to survey and evaluate the status of sexual development in boys from Zhengzhou area and to explore their influencing factors. Methods The height, weight, waist circumference, hip circumference, penis and testicles in 3779 boys aged from 6 to 13 years old in Zhengzhou were measured .The penis length and testicular volume of different ages and their influencing factors were compared, and the beginning age and sexual development characteristics were explored .The development of genitalia and pubes were evaluated by Tanner staging criteria and standards, which were divided into five stages. Results There were 3779 boys, including 395 overweight cases （10.45%） and 208 obesity cases （5.50%）.The testicular volume and penis length increased by age, which increased slowly at the age of 6 to 11, followed by a rapid increase after the age of 11 year old.Testicular volume increased more rapidly than that of penis length. The medians quartile of testicular volume in overweight group ,obese group and normal group were 2.50 mL, 2.50 mL, 2.00 mL, 2.00 mL,2.00 mL,1.00 mL respectively .The testicular volume in overweight group and obese group were significantly greater than that in nor -mal group （P〈0.01） and there were no difference between overweight group and obese group .The penis length in overweight group and obese group were significantly less than that in normal group （P〈0.01）, and there was no difference between overweight group and obese group.Testicular volume and penis length were positively correlated with age, height, weight, body mass index, waist circumference and hip circumference; the correlation between testicular volume and height, penis length and age were the strongest. The age of development of testicle （average 12.02 years） in urban area was later by 2.73 years than that in the rural area （average 9.9 years）, the difference was statistically significant （P〈0.001）.The age of pubic development （P2） and maturity （P5） was （12.34 ±0.83） years and （12.39 ±1.24 ） years.The incidence of precocity in boys was 0.40%. Conclusion The sexual development of boys from Zheng-zhou area is similar to the results of large scale survey from China .Attention should be paid to the effect of obesity on sexual develop-ment, and early intervention should be given, the occurrence of adverse events of sexual development can be avoided .