青春期发育提前女童行为问题的病例对照研究  

Case-control Study on Behavioral Problem of Girls with Earlier Onset of Sexual Development

作　　者：乔晓红[1] 俞建[2] 谢晓恬[1] 

机构地区：[1]同济大学附属同济医院儿科,上海200065 [2]复旦大学附属儿科医院中医科,上海200032

出　　处：《中国心理卫生杂志》2008年第4期249-252,共4页Chinese Mental Health Journal

摘　　要：目的：探讨青春期发育提前女童，即真性性早熟及单纯乳房早发育对女童行为问题的影响及相关因素。方法：采用Achenbach儿童行为量表、家庭环境量表及家庭情况调查表对真性性早熟女童46例，单纯乳房早发育女童46例及同龄正常女童50例进行评定。结果：1．真性性早熟组、单纯早发育组、对照组行为问题检出率分别为45．7％、34．8％、16．0％，两组早发育女童均高于对照组（x^2=9．99、4．51，P分别为0．002和0．034），两组早发育组间检出率差异无统计学意义（x^2=1．13，P=0．288）。2．两组发育提前的女童行为问题总分平均秩次（91．2、82．3）显著高于对照组（43．4），抑郁、体诉、社交退缩等因子得分亦显著高于对照组（如抑郁因子分89．2，79．1／48．2）。3．Tanner分期与抑郁、社交退缩、体诉、违纪、内向因子、外向因子方面呈正相关（r=0．37～0．47，P〈0．05）。4．家庭环境因素中矛盾性、娱乐性影响行为问题评分（β=0．3、0．4）。结论：1．两类发育提前女童行为问题均多于正常女童。2．单纯早发育女童与真性性早熟女童相比，行为问题仍较严重。3．乳房增大可能是引起发育提前女童行为异常的危险因素。Objective： To evaluate the degree of behavioral problem in girls with true precocious puberty and premature thelarche, and to explore the related factors. Methods： 46 girls with true precocious puberty and 46 girls with premature thelarche consisted the two research groups, other 50 normal girls as control group （ n = 50 ） . Their parents completed a Child Behavior Check-list （ CBCL ） , Family Environment Scale （ FES ） and a questionnaire on background status. Results： 1. The prevalence of the behavior problems in girls with true precocious puberty or with premature thelarche were 45.7% and 34. 8% respectively, both rates were significantly higher than that of the control group （16.0%, x^2 = 9.99, 4. 51 ; P = 0. 002, 0. 034 ） ; Higher scores of total behavior problems were found in the girls of true precocious puberty （91.2） and premature thelarehe （82. 3） than those of the control group （43.4） . The two research groups had no significant difference in rate of behavior problems. 2. The scores of internal behavior problems, external behavior problems, depression, withdrawn, somatic complaints, attention problems, social problems, delinquent behavior and aggressive behavior at CBCL were also higher in the girls of the two research groups than those of the control group, such as that of depression were 89.2, 79.1/48.2. Significant positive correlations were found between several behavior problems and Tanner scale （ r = 0. 37 ～0.47, P 〈 0.05 ） . 4. Family entertainment and conflicts had effects on behavior problems scoring （ 13 = 0. 3, 0. 4） . Conclusion： 1. Girls with true precocious puberty and premature thelarche showed more behavior problems than control. 2. Girls with true precocious puberty show more severe behavior problems than those girls with premature thelarche. 3. Enlarged breast is a risk factor behavior problems.

关 键 词：性早熟 儿童行为量表 家庭环境量表 行为问题 病例对照研究 

分 类 号：R179[医药卫生—妇幼卫生保健] B844.1[医药卫生—公共卫生与预防医学]