血清邻苯二甲酸二辛酯水平与女童性早熟的相关性研究

Study on Correlation of Serum Diethylhexyl Phthalate in Girls with Precocious Puberty

目的:探讨性早熟女童血清邻苯二甲酸二辛酯(DEHP)水平变化及其与性早熟的相关性。方法:以性早熟女童(性早熟组)和健康女童(对照组)各78例为研究对象,采用气相色谱法测定其空腹血清DEHP水平,依据病史、体格检查和辅助检查结果将性早熟分型,比较不同组别、临床类型之间血清DEHP水平并分析其水平高低与临床因素的相关性。结果:与对照组比较,性早熟组的身高、体质量和体脂肪率均显著升高(P<0.05),其中体脂肪率均值高出约10%;78例性早熟组中,34例为中枢性性早熟(CPP),44例为外周性性早熟(PPP);对照组、CPP组及PPP组血清DEHP检出率分别为39.74%、88.24%和95.45%,与对照组比较,CPP组及PPP组血清DEHP检出率及水平均显著升高(P<0.05);CPP组血清DEHP水平与LH峰值(r=0.912,P=0.002)、子宫体积(r=0.887,P=0.004)和卵巢体积(r=0.889,P=0.017)正相关;PPP组血清DEHP水平与子宫体积(r=0.916,P=0.003)正相关。结论:血清DEHP水平是影响女童性早熟的重要因素,其水平升高与性腺轴功能提前激活、生殖器官提前发育和第二性征提前呈现密切相关。

Objective：To explore the correlation between the serum diethylhexyl phthalate（DEHP）levels of precocious puberty girls and sexual maturity.Methods：The value of fasting serum DEHP were measured in 78 precocious puberty girls（PP group）and 78 healthy girls（control group）by gas chromatography.According to the medical history,physical examination and auxiliary examination results,precocious puberty girls would be divided into different clinical types,to compare serum DEHP levels among different groups and clinical types,then analyze the DEHP levels and the correlation between the levels and the clinical factors.Results：Compared with the control group,the body height,body weight and body fat percentage of PP group increased significantly（P〈0.05）,for instance,the body fat percentage went up by about 10 percent surely on average.In 78 cases of PP group,34 cases were central precocious puberty（CPP）,and 44 cases were peripheral precocious puberty（PPP）;The detection rates of DEHP in the control group,CPP group and PPP group were 39.74%,88.24%and 95.45%respectively.Compared with the control group,the detection rates and levels of DEHP in CPP group and PPP group increased significantly（P〈0.05）.Peak value of LH（r=0.912,P=0.002）,uterine volume（r=0.887,P=0.004）and ovarian volume（r=0.889,P=0.017）were positively associated with serum DEHP levels of CPP group respectively.The uterine volume（r=0.916,P=0.003）was positively associated with serum DEHP levels of PPP group.Conclusion：The serum level of DEHP is an important factor that affects girls with precocious puberty,and its increased level are closely related to the function of gonad axis activation in advance,reproductive organ development in advance and secondary sexual characteristics presented in advance.