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目的研究和探讨环境内分泌干扰物(EED)与儿童性早熟发病的关系。方法收集2004年5月至2005年9月在性早熟专科门诊就诊的初诊患儿79例及正常儿童42名。运用反相高效液相色谱分析法测定性早熟患儿及正常儿童血清中4-壬基酚(4-NP)、二氯二苯二氯乙烯(p,p′-DDE)和邻苯二甲酸-2-乙基己酯(DEHP)的含量。同时测定患儿子宫和卵巢体积、骨密度及血清雌二醇(E2)含量。将血清EED含量与靶器官的临床指标做相关性分析及多元线性回归分析。结果正常儿童血清中均检测到一定含量的p,p-′DDE(14.93~40.39 ng/m l),部分正常儿童血清中检测到一定含量的4-NP及DEHP(未检出~6.77 ng/m l,未检出~17.61 ng/m l)。性早熟患儿血清中4-NP(未检出~16.68 ng/m l)、p,p-′DDE(40.03~91.68 ng/m l)及DEHP(未检出~64.71 ng/m l)含量高于正常儿童。性早熟患儿血清中4-NP与子宫体积、卵巢体积和骨密度均呈显著正相关;p,p-′DDE与子宫体积呈显著正相关。4-NP对子宫体积的影响强度是p,p-′DDE的1.3倍。结论儿童较为普遍地受到环境内分泌干扰物的污染,环境内分泌干扰物的污染与儿童性早熟的发病有密切关系,是其重要致病因素之一;不同种类的环境内分泌干扰物对靶器官的致病作用强度有所不同。
Objective To study and explore the relationship between environmental endocrine disruptors (EED) and the pathogenesis of precocious puberty in children. Methods From May 2004 to September 2005, 79 newly diagnosed children and 42 normal children were enrolled in this study. The contents of 4-NP, DDP and p-phthalaldehyde in children with precocious puberty and normal children were determined by RP-HPLC. -2-ethylhexyl ester (DEHP) content. At the same time, the uterus and ovary volume, bone mineral density and serum estradiol (E2) content were measured. Correlation analysis between serum EED content and clinical target of target organ and multiple linear regression analysis. Results Some normal serum levels of p, p-DED (14.93-40.39 ng / ml) were detected in normal children. Some normal serum levels of 4-NP and DEHP were detected (~ 6.77 ng / ml , Undetected ~ 17.61 ng / ml). The levels of 4-NP (undetected ~ 16.68 ng / ml), p, p-’DDE (40.03-91.68 ng / ml) and DEHP (undetected ~ 64.71 ng / ml) in patients with precocious puberty were higher than normal child. Premature children with serum 4-NP and uterine volume, ovarian volume and bone mineral density were significantly positive correlation; p, p-’DED and uterine volume was positively correlated. The effect of 4-NP on uterine volume was 1.3 times p, p-’DDE. Conclusions Children are more commonly contaminated by environmental endocrine disruptors. The pollution of environmental endocrine disruptors is closely related to the pathogenesis of precocious puberty in children, which is one of the important causative factors. Different types of environmental endocrine disruptors may cause target organ damage Sickness intensity is different.