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作 者:张金山[1] 侯冬青[2] 李辉[3] 王亚军[1] 米杰[2] 陈芳芳[2] 王天有[1]
机构地区:[1]首都儿科研究所内科,北京100020 [2]首都儿科研究所流行病学研究室,北京100020 [3]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269-272,共4页Chinese Journal of Evidence Based Pediatrics
基 金:北京市科技计划重点项目(H030930030130)(H030930030230)
摘 要:目的 了解北京市6~18岁学龄男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9815名6~18岁中、小学儿童青少年男性的青春期第二性征发育数据,用单位概率回归法计算首次遗精年龄、外生殖器、阴毛、睾丸开始发育年龄。9岁前阴毛达TannerⅡ期(P2),或睾丸体积〉4mL者被定义为性早熟。结果 9815名6~18岁男性儿童青少年中城区4958人,占总样本50.5%,郊区(县)4857人,占总样本量的49.5%:北京市学龄男性首次遗精年龄为(14.4±1.2)岁,其中城区男性(14.1±1.1)岁,郊区(县)男性(14.8±1.2)岁;睾丸体积达4mL时的中位年龄总体、城区和郊区(县)分别为:(10.7±1.2)岁、(10.8±1.2)岁和(10.7±1.2)岁;阴毛开始发育(P2)中位年龄总体、城区和郊区(县)分别为:(12.2±1.1)岁、(12.0±1.1)岁和(12.4±1.1)岁。城区男性首次遗精年龄、睾丸及阴毛开始发育的年龄均早于郊区(县)男性,差异有统计学意义。依据阴毛和睾丸体积来诊断的性早熟率分别为1.92%和0.17%。结论 北京学龄男性首次遗精、睾丸及阴毛开始发育的年龄存在城区和郊区(县)差别。需要广泛开展男性青春期发育规律的研究,尽早建立适合我国儿童青少年的评价标准。Objective To determine the current status of pubertal development and prevalence of sexual precocity among Beijing school-aged boys. Methods As part of the Beijing Child and Adolescent Metabolic Syndrome Study (BCAMS) , a crosssectional study on the presence of secondary sexual characteristics among 9 815 school-aged boys 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 genital and pubic hair development were assessed through visual inspection using standardized drawings and descriptions based on Tanner criteria. The larger-sided testicular size was measured using Prader orchidometer and recorded in milliliters. Age at spermarche was collected by self-report. Status quo method and probit transformation analysis were used to calculate the median age at spermarche and at onset of pubic hair ( P2 ) , gentile ( G2 ) and the age at testicular volume 4 mL. Sexual precocity was defined as onset of P2 or one-sided testicular volume 4 mL before 9 years old. Results Data were analyzed for 9 815 boys,of whom 50. 5% were residing in urban areas and 49. 5 % in rural areas. Spermarche was at age of ( 14. 4 ± 1.2) years old in all boys, ( 14. 1 ± 1.1 ) years old in urban boys and ( 14. 8 ± 1.2) years old in rural boys. The median age of P2 was ( 12. 2 ± 1.2) years old for all, ( 12. 0 ± 1.2) years old for urban boys and ( 12. 4 ± 1.2) years old for rural boys. Testicular development ( ≥4 mL) was observed at age of ( 10. 7 ± 1.2) years old for all, ( 10. 8 ± 1.2) years old for urban boys and ( 10. 7 ± 1.2) years old for rural boys. The prevalence rates of sexual precocity according to pubic hair and testicular size were 1.92% and 0. 17%, respectively. Conclusions Difference of pubertal development staging between urban boys and rural boys was observed in this study. More studies on pubertal development in boys are necessary.
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