内分泌干扰物双酚A和邻苯二甲酸二乙酯与婴幼儿女童乳房早发育的相关性  

Relationship of endocrine disruptors(bisphenol A and diethyl phthalate)with premature thelarche in infant girls

作　　者：曾燕[1] 胡红[2] 

机构地区：[1]重庆医科大学附属儿童医院内分泌科,重庆400014 [2]解放军后勤工程学院院务部门诊部,重庆401311

出　　处：《第二军医大学学报》2015年第9期1021-1024,共4页Academic Journal of Second Military Medical University

摘　　要：目的探讨内分泌干扰物（endocrine disrupting compounds,EDCs）与0~3岁婴幼儿女童乳房早发育（premature thelarche,PT）的相关关系。方法 采用病例-对照研究收集2013年8月至2014年6月于重庆医科大学附属儿童医院儿科就诊并诊断为单纯乳房发育的女童60例为病例组,正常健康女童60例为对照组。分别由家长填写调查问卷并对其进行B超检查。由专业实验人员采集女童血清,测定其雌二醇（estradiol,E2）、促卵泡激素（follicle stimulating hormone,FSH）、促黄体激素（luteinizing hormone,LH）、双酚A（bisphenol A,BPA）和邻苯二甲酸二乙酯（diethyl phthalate,DEP）等水平并进行比较。结果 病例组较对照组的年龄、FSH和LH差异均无统计学意义（P值分别为0.745、0.721、0.195）,而病例组的E2分泌高于对照组,两组间差异有统计学意义（t=5.765,P=0.017）;病例组的BPA以及DEP的含量均远远高于对照组[（272.9±101.3）μg/L vs（21.8±18.4）μg/L;（0.8±0.3）mg/L vs（0.3±0.1）mg/L],差异均有统计学意义（P=0.000,P=0.000）。病例组的BPA与DEP存在正相关性（r=0.601,P=0.002）,而对照组患者血清中的两种物质无相关性（r=0.302,P=0.102）;各组性激素与两种分内分泌干扰物间的数据相关系数均无统计学意义（P〉0.05）。结论 体内雌激素水平以及BPA和DEP等与0~3岁女童的乳房早发育具有重要关联,且遗传因素与环境因素之间无明显相关关系。Objective To study the relationship of endocrine disruptors （EDCs） with premature thelarche in the 0-3 years old baby girls. Methods A total of 60 infant girls diagnosed with premature thelarche were selected as the case group in Children＇s Hospital Affiliated to Chongqing Medical University between August 2013 and June 2014, and another 60 healthy girls were included into a control group. Their parents were asked to finish questionnaires and each participants underwent B ultrasonic examination The serum samples were obtained from both groups by professional doctors to examine the levels of estradiol, follicle stimulation hormone, luteinizing hormone, bisphenol A and diethyl phthalate. Results There were no significant differences in the age, FSH or LH levels between the case group and the control group （P= 0. 745, 0. 721 and 0. 195, respectively）; the level of E2 in the case group was significantly higher than that in the control group （P=0. 017）; bisphenol A and diethyl phthalate levels in the case group were significantly higher than those in the control group （[272. 9± 101.3] μg/L vs [-21.8±18. 4] μg/L, P=0. 000; [0. 8±0. 3] mg/L vs [0. 3±0. 1] mg/L,P=0. 000）. There was a positive correlation between the bisphenol A and diethyl phthalate in the case group （r=0. 061, P=0. 002）, but not in the control group （r=0. 302,P= 0. 102）. There was no significant correlation between the sex hormone and the two EDCs （bisphenol A or diethyl phthalate） （P〉0. 05）. Conclusion Premature thelarche in the infant girls between 0 and 3 years old is associated with serum estrogen level, bisphenol A and ethyl phthalate levels, and there is no relationship between genetic factors and environmental factors.

关 键 词：乳房早发育 双酚A 邻苯二甲酸二乙酯 内分泌干扰物 

分 类 号：R725.85[医药卫生—儿科]