摘要
目的:通过调查浙江省湖州地区女童尿液中邻苯二甲酸酯(PAEs)暴露水平,探讨其与女童性早熟发病的关系。方法:选择2018年7月—2019年12月就诊于湖州市妇幼保健院小儿内分泌专科的84例性早熟女童作为性早熟组,选取同年龄段无乳房发育的女童50名作为对照组。测定两组女童晨尿中5种PAEs代谢产物的浓度,分别为邻苯二甲酸单甲酯(MMP)、邻苯二甲酸单乙酯(MEP)、邻苯二甲酸单丁酯(MBP)、邻苯二甲酸单丁苄酯(MBzP)和邻苯二甲酸单乙基己基酯(MEHP),同时结合患儿的血清性激素基础值、BMI值、骨龄、子宫卵巢体积和LHRH激发峰值,比较和分析3组间的差异。结果:(1)134例尿液样本中,5种PAEs代谢产物检出率依次为MBP(54.39%)、MEHP(41.22%)、MMP(1.75%),MEP和MBzP未检出;性早熟组尿液中MBP和MEHP检出率及质量浓度均高于对照组,差异有统计学意义(χ_(MBP)^(2) =9.007,χ_(MEHP)^(2) =8.323;H_(MBP)=14.15,H_(MEHP)=8.08;P<0.05)。(2)性早熟女童中,尿液MBP和MEHP检出组子宫体积为(2.72±0.75)cm3,大于未检出组[(2.34±0.81)cm3],差异有统计学意义(t=2.08,P<0.05);骨龄与实际年龄差检出组[(1.56±0.57)年]大于未检出组[(1.22±0.48)年],差异有统计学意义(t=2.58,P<0.05)。(3)湖州区县乡镇女童MBP和MEHP的检出率为71.1%,显著高于城区女童尿液检出率47.8%,二者比较差异有统汁学意义(χ^(2)=4.619,P=0.032)。结论:PAEs污染与女童性早熟的发生存在相关性,其水平升高与骨龄进展,生殖器官提前发育密切相关,应引起重视。
OBJECTIVE To study the effect of Pathalic Acid Esters(PAEs)to precocious puberty in girls.METHODS A total of 84 cases of precocious puberty girls in endocrine clinic from July 2018 to December 2019 were selected as precocious puberty group.50 cases with no puberty development girls were chosen as control group.The exposure levels of five PAEs metabolites were determined with UPLC-MS/MS in urine samples,including monomethyl phthalate(MMP),monoethyl phthalate(MEP),monobutyl phthalate(MBP),butyl benzyl phthalate(MBzP),mono(2-ethylhexyl)phthalate(MEHP),the differences among the three groups were compared and the relationships between PAEs and precocious puberty were analyzed.RESULTS Of the 134 urine samples,the detection rate of PAEs metabolites was MBP(54.39%)MEHP(41.22%)MMP(1.75%),MBP and MEHP rele⁃vance ratio and concentration in precocious puberty group were higher than those of control group(χ_(MBP)^(2)=9.007,χ_(MEHP)^(2)=8.323;H_(MBP)=14.15,H_(MEHP)=8.08;P<0.05).Bone-age advancement and in MBP and MEHP detected group were higher than those of undetected group(t=2.58,P<0.05).Compared uterus volume of MBP and MEHP detected group[(2.72±0.75)cm3]with undetected group[(2.34±0.81)cm3],there was significent difference(t=2.08,P<0.05).MBP and MEHP in urine were detected in 71.1%patients living in the countryside,and the rate was obviously higher than 47.8%of the patients living in the cities(P<0.05).CONCLU⁃SIONS There was a certain correlation between the concentrations of PAEs and precocious puberty in girls,especially the bone-age advancement.
作者
金薇
王红丽
邓庆先
高毅
JIN Wei;WANG Hong-li;DENG Qing-xian;GAO Yi(Department of Pediatrics,Huzhou Maternity&Child Health Care Hospital,Huzhou,Zhejiang,313000,China)
出处
《中国初级卫生保健》
2021年第7期60-62,共3页
Chinese Primary Health Care
基金
浙江省湖州市科技计划公益类项目(2018GY27)。
关键词
邻苯二甲酸酯
性早熟
女童
Pathalic Acid Esters
precocious puberty
girls
