中国9~18岁儿童青少年首次遗精/月经初潮与心理困扰的关联研究  

Research on the association between the occurrence of spermarche and menarche and psychological distress among Chinese children and adolescents aged 9-18 years

作　　者：张依航 蔡珊 陈子玥 张奕[1] 蒋家诺 刘云飞 党佳佳 钟盼亮 师嫡 董彦会 胡佩瑾[1] 朱广荣[1] 马军[1] 宋逸[1] Zhang Yihang;Cai Shan;Chen Ziyue;Zhang Yi;Jiang Jianuo;Liu Yunfei;Dang Jiajia;Zhong Panliang;Shi Di;Dong Yanhui;Hu Peijin;Zhu Guangrong;Ma Jun;Song Yi(Institute of Child and Adolescent Health,Peking University/School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院/北京大学儿童青少年卫生研究所,北京100191

出　　处：《中华流行病学杂志》2023年第10期1545-1551,共7页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(82273654)。

摘　　要：目的分析中国9~18岁汉族儿童青少年首次遗精/月经初潮的发生与心理困扰情况的关联。方法使用2019年全国学生体质与健康调研数据, 共选取首次遗精/月经初潮和心理困扰情况记录资料完整的11~18岁男生54 438名和9~18岁女生76 376名。是否发生首次遗精/月经初潮由内科医生询问记录, 心理困扰程度根据凯斯勒心理困扰量表得分判定。使用χ2检验比较各年龄组心理困扰率和首次遗精/月经初潮发生率的差异、采用多因素logistic回归模型分层分析各年龄组男女生存在心理困扰与发生首次遗精/月经初潮的关联。结果 2019年中国男生8个年龄组首次遗精发生率为6.3%~96.5%, 女生10个年龄组月经初潮发生率为2.8%~99.0%, 男女生高心理困扰率分别为32.5%和32.7%。11~18岁男生中, 高心理困扰率随年龄增加而升高, 趋势检验P<0.001, 各年龄组已出现与未出现首次遗精者高心理困扰率差异无统计学意义。9~18岁女生中, 高心理困扰率随年龄增加而升高, 趋势检验P<0.001, 10岁及12岁已出现月经初潮组高心理困扰率高于未出现月经初潮组, 差异有统计学意义(均P<0.05)。高心理困扰与居住在城市及经济发展水平高片区的13~15岁男生首次遗精发生呈正相关(OR=1.11, 95%CI:1.02~1.21;OR=1.18, 95%CI:1.06~1.32)。总体上, 9~12岁、13~15岁女生高心理困扰与月经初潮发生呈正相关(OR=1.33, 95%CI:1.25~1.42;OR=1.22, 95%CI:1.07~1.39)。高心理困扰与居住在除东北部地区外不同地区、经济发展水平片区及城乡的9~12岁女生, 居住在城市、中部及西部地区的13~15岁女生以及居住在中部地区的16~18岁女生月经初潮的发生呈正相关。结论 2019年中国9~18岁汉族儿童青少年首次遗精/月经初潮的发生与心理困扰情况存在关联, 在9~12岁女生和生活在社会经济发展水平较高地区的13~15岁男生中尤为显著。Objective To analyze the association between the occurrence of spermarche and menarche and psychological distress among Chinese Han children and adolescents aged 9 to 18 years.Methods Data were drawn from the 2019 Chinese National Survey on Students'Constitution and Health,and a total of 54438 boys aged 11 to 18 years and 76376 girls aged 9 to 18 years with psychological distress,spermarche/menarche records were included in the final analysis.The occurrence of spermarche/menarche was recorded by physicians,and psychological distress was classified according to the Kessler Psychological Distress Scale scores.The chi-square test was used to compare the difference between groups in the occurrence of spermarche/menarche,and the multinomial logistic regression model and stratification analysis was established to analyze the association between psychological distress and spermarche/menarche.Results The incidence of spermarche/menarche in 2019 ranged from 6.3%to 96.5%for eight age groups of Chinese boys and 2.8%to 99.0%for ten age groups of girls.The rates of high psychological distress among boys and girls were 32.5%and 32.7%.Among boys aged 11 to 18 years,the rate of high psychological distress increased with age,with a trend test P<0.001,and the difference in the rate of high psychological distress between those who had and had not had their spermarche was not statistically significant in all age groups.Among girls aged 9 to 18 years,the rate of high psychological distress increased with age,with a trend P<0.001;the rate of high psychological distress was higher in the group with menarche at age 10 and 12 than in the group without menarche(all P<0.05).High psychological distress was positively correlated with spermarche among boys aged 13-15 years living in urban areas and hight level economic development areas(OR=1.11,95%CI:1.02-1.21;OR=1.18,95%CI:1.06-1.32).Overall,high psychological distress was positively correlated with menarche in girls aged 9-12 and 13-15 years(OR=1.33,95%CI:1.25-1.42;OR=1.22,95%CI:1.07-1.39).

关 键 词：首次遗精 月经初潮 心理困扰 儿童 青少年 

分 类 号：R179[医药卫生—妇幼卫生保健]