北京市儿童青少年女性青春期性征发育流行病学研究  

Update pubertal development in Beijing school-aged girls

作　　者：侯冬青[1] 李辉[2] 孙淑英[2] 夏秀兰[2] 陈芳芳[1] 米杰[1] 

机构地区：[1]首都儿科研究所流行病学研究室,北京100020 [2]首都儿科研究所生长发育研究室,北京100020

出　　处：《中国循证儿科杂志》2006年第4期264-268,共5页Chinese Journal of Evidence Based Pediatrics

基　　金：北京市科技计划重点项目(H030930030130)

摘　　要：目的 了解北京市6～18岁学龄女性青春期第二性征发育现状，以及人群性早熟发生率。方法 利用2004年北京市儿童代谢综合征调查总样本中9778名6～18岁中、小学女性儿童青少年的青春期第二性征发育数据，用概率单位回归法计算月经初潮、乳房和阴毛不同发育时期的中位年龄。8岁前乳房或阴毛发育达Tanner Ⅱ期（B2，P2），或10岁前月经初潮者被定义为性早熟。结果 9778名女性儿童青少年中城区5040人，占总样本51．5％，郊区（县）4738人，占总样本的48．5％。北京市学龄女性月经初潮平均年龄为（12．1±1．1）岁，城区女性（11．9±1．1）岁，郊区（县）女性（12．5±1．1）岁；女性第二性征开始发育年龄总体、城区和郊区（县）分别为：乳房：（9．5±1．2）岁、（9．4±1．1）岁和（9．6±1．2）岁；阴毛：（11．1±1．1）岁、（10．8±1．1）岁和（11．4±1．1）岁。城区女性月经初潮、乳房和阴毛发育均显著早于郊区（县）女性。月经初潮早发生率为0．79％，城区高于郊区（县）（1．03％vs0．55％；x^2=6．93，P〈0．01）；乳房、阴毛早发育率分别为2．91％和0．22％。1962～1982年北京女性月经初潮年龄平均每10年提前0．7岁（8．4个月）；近10年平均提前0．43岁（5．2个月）。结论北京市城区女性青春期第二性征发育明显早于郊区（县）女性。月经初潮年龄提前的长期变化趋势依然存在，但近10年这一趋势趋于减缓。Objective To determine the current status of pubertal development and prevalence of sexual precocity among Beijing school-aged girls. Methods As part of the Beijing Child and Adolescent Metabolic Syndrome Study （BCAMS） ,a crosssectional study on the presence of secondary sexual characteristics among 9 778 school-aged girls aged 6 ～ 18 years old was undertaken in Beijing city from April to October 2004. All participants completed a questionnaire on demographic variables. The stages of breast and pubic hair development were assessed through visual inspection using standardized drawings and descriptions based on Tanner criteria. Palpation was required for the assessment of breast stage in order to distinguish adiposity and galactophore. Age at menarche was collected by self-report. Status quo method or probit transformation analysis were used to calculated the median age at menarche and at onset of breast （B2） and pubic hair （P2）. Sexual precocity was defined as onset of B2 or P2 before 8 years old,or menarche before 10 years old. Results Among 9 778 girls who participated in this study,5 040 girls （51.5% ） were residing in urban areas. The median menarcheal age was 12.1 （SD = 1.1 ） years old in Beijing girls,urban girls experienced menarche,on average,0.6 years （7.2 months） earlier than girls in rural areas did[ （ 11.9 ± 1.1 vs 12.5 ± 1.1 ） years old]. Tanner breast 2 stage （B2） was present at （9.5 ± 1.2 ）years old in all girls, （9.4 ± 1.1 ） years old in urban girls,and （ 9.6±1.2 ）years old in rural girls. Age at onset of pubic hair （P2） was （11.1±1. 1） years old,10.8±1. 1 years old and （11.4±1.1 ） years old in all,urban girls and rural girls, respectively. Comparison with historical data,menarcheal age of Beijing girls has been advanced by 2.1 years since 1962,when the menarche began at 14. 16 years,on average of 0. 7 years （8. 4 months） per decade during 1962 - 1982 ,and decreased to 0. 43 years （5.2 months） per decade during 1992 - 2004. T

关 键 词：学龄儿童青少年 女性 第二性征 性早熟 

分 类 号：R181.3[医药卫生—流行病学]