2014年上海市小学生青春期性征发育状况调查  

Update on pubertal development among primary school students in Shanghai, 2014

作　　者：陈瑶[1] 张云婷[2] 陈畅[3] 姜艳蕊[4] 宋沅瑾 刘世建[3] 江帆[4] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心内分泌与遗传代谢疾病科教育部和上海市环境与儿童健康重点实验室,200127 [2]上海交通大学医学院附属上海儿童医学中心内分泌与遗传代谢疾病科教育部儿童健康管理研究所,200127 [3]上海交通大学医学院公共卫生学院 [4]上海交通大学医学院发育行为儿科

出　　处：《中华预防医学杂志》2016年第11期971-975,共5页Chinese Journal of Preventive Medicine

基　　金：国家重点基础研究发展计划（2010CB535000）;国家自然科学基金（81422040、81172685）;教育部新世纪优秀人才支持计划（NCET-13-0362）;上海市科学技术委员会科研计划项目（12411950405、14441904004、13QH1401800）;上海市公共卫生体系建设三年行动计划（2015-2017年,GWIV-36）;上海市教育科学研究重大项目（D1502）

摘　　要：目的调查上海市小学生青春期性征发育现状。方法于2014年6月采用多阶段整群抽样方法，选取上海市小学一年级至五年级学生共17571名。调查女生乳房及阴毛发育Tanner分期，男生睾丸容积及阴毛发育Tanner分期，女生月经、男生遗精是否发生及初次发生时间。计算女生及男生性早熟检出率，6—7岁女生乳房发育≥B2及阴毛发育≥PH2检出率，6~9岁女生月经初潮检出率，6-8岁男生睾丸容积≥4ml及阴毛发育≥PH2检出率，并采用逆概率加权法对数据进行抽样权重调整。结果最后纳入16197名6～11岁小学生进行分析。进行权重调整后，女生6—7岁出现乳房发育≥B2的检出率为17．2％，6-7岁出现阴毛发育》PH2的检出率为2．5％，6～9岁已发生月经初潮的检出率为0．3％，小学一年级到五年级女生已发生月经初潮的检出率为4．7％；按目前性早熟界定方法，6—7岁女生性早熟检出率为19．0％。男生6～8岁睾丸容积≥4ml的检出率为1．7％，6-8岁阴毛发育≥PH2的检出率为0．6％，小学一年级到五年级男生已发生遗精的检出率为0．1％；按目前性早熟界定方法，6-8岁男生性早熟检出率为2．3％。结论上海小学生尤其是女生普遍存在青春期性征发育提前情况，在小学阶段针对性开展青春期教育及性教育十分必要。Objective To investigate the current prevalence of pubertal development in healthy Shanghai schoolchildren. Methods This study was a cross-sectional investigation focused on current pubertal development conducted in healthy Shanghai schoolchildren by multi-stage cluster sampling. The sample included 17 571 children in grades 1-5 investigated in June 2014. The data were weighted by inverse probability weighting （IPW） to make them more representative. At examination, stages of breast and pubic hair development were rated according to the Tanner method. Testicular volume was determined. Data on menarche and spermatorrhea were collected by the status quo method. The rates of precocious puberty, breast, and pubic hair development of Tanner stage≥Ⅱ in girls aged 6-7 years, menarche in girls aged 6-9 years, and testicular volume 〉14ml and pubic hair development of Tanner stage ≥Ⅱ in boys aged 6-8 years were calculated. All the data were weighted by IPW. Results After data processing, 16 197 children＇s data were analyzed. In girls aged 6-7 years, 17,2% and 2.5% showed evidence of breast and pubic hair development at Tanner stage ≥Ⅱ, respectively. In girls aged 6-9 years, 0.3% had experienced menarche. Schoolgirls＇ rate of menarche was 4.7%. In girls aged 6-7 years, 19.0% were diagnosed with precocious puberty according to the classic criteria. In boys aged 6-8 years, 1.7% had testicular volume ≥4 ml, and 0.6% showed evidence of pubic hair development at Tanner stage ≥Ⅱ. Schoolboys＇ incidence rate of spermatorrhea was 0.1%. In boys aged 6-8 years, 2.3% were diagnosed with precocious puberty according to the classic criteria. All the numbers above were weighted. Conclusion Proper education on adolescence and sex is essential for Shanghai schoolchildren.

关 键 词：性发育 青春期发育 横断面研究 

分 类 号：R179[医药卫生—妇幼卫生保健]