CAJ | 학술논문

目的：男童性发育不仅受年龄因素影响，且与所处环境、地区等因素有关。文中调查及评价郑州地区男童的性发育现状并探讨其影响因素。方法对来自郑州地区3779名6～13岁男童的身高、体重、腰围、臀围、阴茎及睾丸进行测定，比较不同年龄阴茎长度及睾丸容积的变化及影响因素，以及性发育的首发年龄及其特征。依据Tanner分期标准及标准图谱对受试者外生殖器和阴毛的发育情况进行分期评定，均分为5期。结果睾丸容积、阴茎长度随年龄增加而增大，在6～11岁时增加缓慢，11岁后迅速增加。睾丸容积增加幅度大于阴茎长度。3779名男童中超重395名（10．45％），肥胖208名（5．50％），正常组、超重组、肥胖组睾丸体积的平均秩次分别为1760．47、2036．20、1889．86，经秩和检验，3组间比较有显著差异（H＝27．01，P＝0．00），正常组与超重组睾丸体积比较有差异，超重组睾丸体积大于正常组（P＝0．00）；正常组、超重组与肥胖组睾丸体积比较均无差异（P＝0．08，P ＝0．10）；超重组、肥胖组的阴茎长度均明显小于正常组（P＜0．01），超重组与肥胖组阴茎长度比较无差异。睾丸容积、阴茎长度均与年龄、身高、体重、 BMI、腰围、臀围呈正相关，其中睾丸容积与身高相关性最强，而阴茎长度与年龄相关性最强。城区男童睾丸开始发育的年龄（平均12．02岁）晚于郊县（平均9．90岁）2．73岁，差异有统计学意义（P＜0．01）；阴毛开始发育（P2）和成熟（P5）的平均年龄分别为（12．34±0．83）岁和（12．39±1．24）岁。男童性早熟发生率为0．40％。结论郑州地区男童的性发育趋势与中国大规模调查结果接近，但对于肥胖对性发育的影响应引起相关部门的高度重视，尽早干预，避免性发育不良事件的发生。
목적：남동성발육불부수년령인소영향，차여소처배경、지구등인소유관。문중조사급평개정주지구남동적성발육현상병탐토기영향인소。방법대래자정주지구3779명6～13세남동적신고、체중、요위、둔위、음경급고환진행측정，비교불동년령음경장도급고환용적적변화급영향인소，이급성발육적수발년령급기특정。의거Tanner분기표준급표준도보대수시자외생식기화음모적발육정황진행분기평정，균분위5기。결과고환용적、음경장도수년령증가이증대，재6～11세시증가완만，11세후신속증가。고환용적증가폭도대우음경장도。3779명남동중초중395명（10．45％），비반208명（5．50％），정상조、초중조、비반조고환체적적평균질차분별위1760．47、2036．20、1889．86，경질화검험，3조간비교유현저차이（H＝27．01，P＝0．00），정상조여초중조고환체적비교유차이，초중조고환체적대우정상조（P＝0．00）；정상조、초중조여비반조고환체적비교균무차이（P＝0．08，P ＝0．10）；초중조、비반조적음경장도균명현소우정상조（P＜0．01），초중조여비반조음경장도비교무차이。고환용적、음경장도균여년령、신고、체중、 BMI、요위、둔위정정상관，기중고환용적여신고상관성최강，이음경장도여년령상관성최강。성구남동고환개시발육적년령（평균12．02세）만우교현（평균9．90세）2．73세，차이유통계학의의（P＜0．01）；음모개시발육（P2）화성숙（P5）적평균년령분별위（12．34±0．83）세화（12．39±1．24）세。남동성조숙발생솔위0．40％。결론정주지구남동적성발육추세여중국대규모조사결과접근，단대우비반대성발육적영향응인기상관부문적고도중시，진조간예，피면성발육불량사건적발생。
Objective Boy sexual development is affected not only by age, but also by environment factors .The present study was to survey and evaluate the status of sexual development in boys from Zhengzhou area and to explore their influencing factors. Methods The height, weight, waist circumference, hip circumference, penis and testicles in 3779 boys aged from 6 to 13 years old in Zhengzhou were measured .The penis length and testicular volume of different ages and their influencing factors were compared, and the beginning age and sexual development characteristics were explored .The development of genitalia and pubes were evaluated by Tanner staging criteria and standards, which were divided into five stages. Results There were 3779 boys, including 395 overweight cases (10.45%) and 208 obesity cases (5.50%).The testicular volume and penis length increased by age, which increased slowly at the age of 6 to 11, followed by a rapid increase after the age of 11 year old.Testicular volume increased more rapidly than that of penis length. The medians quartile of testicular volume in overweight group ,obese group and normal group were 2.50 mL, 2.50 mL, 2.00 mL, 2.00 mL,2.00 mL,1.00 mL respectively .The testicular volume in overweight group and obese group were significantly greater than that in nor -mal group (P<0.01) and there were no difference between overweight group and obese group .The penis length in overweight group and obese group were significantly less than that in normal group (P<0.01), and there was no difference between overweight group and obese group.Testicular volume and penis length were positively correlated with age, height, weight, body mass index, waist circumference and hip circumference; the correlation between testicular volume and height, penis length and age were the strongest. The age of development of testicle (average 12.02 years) in urban area was later by 2.73 years than that in the rural area (average 9.9 years), the difference was statistically significant (P<0.001).The age of pubic development (P2) and maturity (P5) was (12.34 ±0.83) years and (12.39 ±1.24 ) years.The incidence of precocity in boys was 0.40%. Conclusion The sexual development of boys from Zheng-zhou area is similar to the results of large scale survey from China .Attention should be paid to the effect of obesity on sexual develop-ment, and early intervention should be given, the occurrence of adverse events of sexual development can be avoided .