环境内分泌干扰物与婴幼儿单纯乳房早发育的临床及转归的相关性研究

Study on the correlation between environmental endocrine disruptors and the clinical features and outcome of isolated premature thelarche in infants

目的探讨环境内分泌干扰物(EDCs)双酚A(BPA)、邻苯二甲酸二乙酯(DEP)、4-壬基酚(4-NP)、邻苯二甲酸二乙基己基酯(DEHP)与婴幼儿单纯乳房早发育(IPT)的临床及转归的相关性。方法收集2015—2016年在江西省儿童医院内分泌遗传代谢科门诊初诊为IPT年龄<2岁的女性患儿62例为病例组(IPT组)并随访2年,健康体检正常女性婴幼儿30例为对照组,观察血清中BPA、DEP、4-NP、DEHP水平与其临床特征及转化的相关性。结果IPT组与对照组比较,雌激素水平、血清中四种EDCs含量差异均有统计学意义,根据随访转归结果,将IPT组分为乳房完全消退组(33例,53.2%)和未消退组(29例,46.7%),但消退组与未消退组内EDCs含量差异均无统计学意义。结论IPT并非完全都可自行消退,环境内分泌干扰物暴露可能是IPT发生的诱因,具体机制仍待进一步研究。

Objective To investigate the correlation between environmental endocrine disruptors(EDCs)[bisphenol A(BPA),diethyl phthalate(DEP),4-nonylphenol(4-NP)and diethylhexyl phthalate(DEHP)]and the clinical features and outcome of isolated premature thelarche(IPT)in female infants.Methods A total of 62 cases of female infants less than 2 years old with IPT admitted to Department of Endocrinology,Metabolism and Genetics,Jiangxi Provincial Children’s Hospital,from 2015 to 2016 were recruited and followed up for 2 years,and 30 cases of healthy female in⁃fants with normal physical examination were recruited as control group,to observe the correlation between serum BPA,DEP,4-NP and DEHP level and the clinical characteristics and outcome.Results The study showed that compared with the control group,the estrogen levels and serum levels of four EDCs were statistically different in IPT group.Accord⁃ing to the results of follow-up outcome,the IPT group was divided into complete regression group(33 cases,53.2%)and incomplete group(29 cases,46.7%),but there was no statistical difference in EDCs content between the regression group and the non-elimination group.Conclusion IPT can not regress completely on its own,exposure of environmen⁃tal endocrine disruptors may be the cause of IPT,and the specific mechanism remains to be further studied.