新生儿肛门生殖器距离与隐睾的相关性分析

Relationship between anogenital distance and cryptorchidism in human newborns

目的:分析男性新生儿肛门生殖器距离(AGD)与睾丸下降不全之间的关系,探索其可能存在的内在联系。方法:连续纳入哈尔滨市妇产医院及哈尔滨市双城区急救中心妇产科2013年9月至2014年9月出生的汉族男性新生儿350例,出生后24 h对所有新生儿测量AGD,排除有合并直肠肛门畸形及尿道下裂的患儿,由小儿外科医生进行体格检查,确定其是否存在睾丸下降不全,并根据睾丸位置分为阴囊上方型、腹股沟型及不可触及型。结果:350例新生儿中隐睾39例,隐睾新生儿的AGD长度显著短于非隐睾新生儿[(2.01±0.22)cm vs(2.35±0.19)cm;P<0.01];在排除早产儿及低出生体重儿情况下该差异仍具有统计学意义[(2.32±0.14)cm vs(2.06±0.19)cm;(2.37±0.17)cm vs(2.12±0.12)cm,P均<0.01];高位隐睾新生儿AGD较低位隐睾儿AGD有降低趋势,但无统计学意义(F=0.434,P>0.05);单侧隐睾与双侧隐睾新生儿AGD值差异也无统计学意义[(1.96±0.13)cm vs(2.02±0.17)cm,P>0.05)]。结论:在所研究的男性新生儿人群中,AGD值与睾丸下降不全具有相关性。AGD可以作为雄激素作用窗口期存在异常干扰的衡量指标。

Objective：To explore the relation of the anogenital distance（ AGD） with cryptorchidism in male newborns.Methods：This study included 350 male infants delivered in two community hospitals between September 2013 and September 2014.Within 24 hours after birth,a pediatric surgeon measured the AGD of the neonates and determined whether they had cryptorchidism.According to the testicular position,we divided the undescended testes into three types：upper scrotal,inguinal,and non-palpable.Results：Totally 39 cases of cryptorchidism were found in the 350 newborns.The AGD of the cryptorchidism infants was significantly shorter than that of the normal neonates（ [2.01 ± 0.22]vs [2.35 ± 0.19]cm,P 〈0.01）,and statistically significant differences remained even when preterm and low birth-weight infants were excluded（[2.32 ± 0.14] vs [2.06 ± 0.19] cm;（2.37 ± 0.17） cm vs（2.12 ± 0.12） cm,all P 〈0.01）.The newborns with higher-position cryptorchidism had a shorter AGD,though with no significant difference（ F = 0.434,P 〉0.05）.No significant differences were observed in the AGD between unilateral and bilateral cryptorchidism（ [1.96 ± 0.13] vs [2.02 ± 0.17] cm,P 〉0.05）.Conclusion：Shorter AGD is associated with a higher incidence of cryptorchidism in male newborns.AGD could serve as a potential biomarker for disruption of androgen action during the male programming window period.