目的 了解0～2岁婴幼儿乳房早发育相关危险因素,分析与其消退相关的原因.方法 对2012年4月-2013年3月在江西省儿童医院内分泌科诊断为单纯乳房早发育的807例婴幼儿进行2年随访跟踪研究,对其家庭、社会因素、生活方式、饮食等再次进行问卷调查并复查基础性血清性激素.结果 807例乳房早发育婴幼儿,失访234例,随访到573例,88.8％(509/573)的单纯乳房早发育患儿能消退,平均消退年龄(16.6±8.3)月龄,11.2％(64/573)退而复现或持续不退,极少数转化为真性性早熟;对来院复查填写问卷调查的213例患儿的相关危险因素进行多因素Logistic 回归分析:家庭附近有污染工厂[优势比(OR)=5.846,95％CI:1.051～ 32.521,P=0.044],父母关系不和睦(OR =4.087,95％CI:1.126～ 14.839,P=0.032),母亲初潮年龄早(OR=3.133,95％CI:1.108～ 8.859,P=0.031),塑料制品(奶瓶、餐具、玩具、食品包装材料等)使用频率高(OR=6.235,95％ CI:1.912～20.336,P=0.002),经常食用动物性食品、高蛋白(OR=3.885,95％CI:1.452～ 10.393,P=0.007)和含防腐剂色素食品(如油炸食品、饮料、膨化食品等,OR=2.927,95％ CI:1.070～8.007,P=0.037),喂养方式(奶粉喂养、混合喂养,OR=7.249,95％ CI:2.000～ 26.280,P=0.003;OR=6.220,95％ CI:1.499～ 25.803,P=0.012),雌二醇水平(OR=8.500,95％CI:2.149～33.618,P=0.002),初诊时乳房大小(OR=5.325,95％ CI:1.744～ 16.257,P=0.003)与乳房早发育婴幼儿的消退密切相关.结论 0～2岁婴幼儿乳房早发育大多数能够消退,对于乳房增大不消退或反复出现的患儿可能与长期高蛋白饮食、频繁接触环境内分泌干扰物有关;持续不消退或退而复现的患儿应行随访.
目的 瞭解0～2歲嬰幼兒乳房早髮育相關危險因素,分析與其消退相關的原因.方法 對2012年4月-2013年3月在江西省兒童醫院內分泌科診斷為單純乳房早髮育的807例嬰幼兒進行2年隨訪跟蹤研究,對其傢庭、社會因素、生活方式、飲食等再次進行問捲調查併複查基礎性血清性激素.結果 807例乳房早髮育嬰幼兒,失訪234例,隨訪到573例,88.8％(509/573)的單純乳房早髮育患兒能消退,平均消退年齡(16.6±8.3)月齡,11.2％(64/573)退而複現或持續不退,極少數轉化為真性性早熟;對來院複查填寫問捲調查的213例患兒的相關危險因素進行多因素Logistic 迴歸分析:傢庭附近有汙染工廠[優勢比(OR)=5.846,95％CI:1.051～ 32.521,P=0.044],父母關繫不和睦(OR =4.087,95％CI:1.126～ 14.839,P=0.032),母親初潮年齡早(OR=3.133,95％CI:1.108～ 8.859,P=0.031),塑料製品(奶瓶、餐具、玩具、食品包裝材料等)使用頻率高(OR=6.235,95％ CI:1.912～20.336,P=0.002),經常食用動物性食品、高蛋白(OR=3.885,95％CI:1.452～ 10.393,P=0.007)和含防腐劑色素食品(如油炸食品、飲料、膨化食品等,OR=2.927,95％ CI:1.070～8.007,P=0.037),餵養方式(奶粉餵養、混閤餵養,OR=7.249,95％ CI:2.000～ 26.280,P=0.003;OR=6.220,95％ CI:1.499～ 25.803,P=0.012),雌二醇水平(OR=8.500,95％CI:2.149～33.618,P=0.002),初診時乳房大小(OR=5.325,95％ CI:1.744～ 16.257,P=0.003)與乳房早髮育嬰幼兒的消退密切相關.結論 0～2歲嬰幼兒乳房早髮育大多數能夠消退,對于乳房增大不消退或反複齣現的患兒可能與長期高蛋白飲食、頻繁接觸環境內分泌榦擾物有關;持續不消退或退而複現的患兒應行隨訪.
목적 료해0～2세영유인유방조발육상관위험인소,분석여기소퇴상관적원인.방법 대2012년4월-2013년3월재강서성인동의원내분비과진단위단순유방조발육적807례영유인진행2년수방근종연구,대기가정、사회인소、생활방식、음식등재차진행문권조사병복사기출성혈청성격소.결과 807례유방조발육영유인,실방234례,수방도573례,88.8％(509/573)적단순유방조발육환인능소퇴,평균소퇴년령(16.6±8.3)월령,11.2％(64/573)퇴이복현혹지속불퇴,겁소수전화위진성성조숙;대래원복사전사문권조사적213례환인적상관위험인소진행다인소Logistic 회귀분석:가정부근유오염공엄[우세비(OR)=5.846,95％CI:1.051～ 32.521,P=0.044],부모관계불화목(OR =4.087,95％CI:1.126～ 14.839,P=0.032),모친초조년령조(OR=3.133,95％CI:1.108～ 8.859,P=0.031),소료제품(내병、찬구、완구、식품포장재료등)사용빈솔고(OR=6.235,95％ CI:1.912～20.336,P=0.002),경상식용동물성식품、고단백(OR=3.885,95％CI:1.452～ 10.393,P=0.007)화함방부제색소식품(여유작식품、음료、팽화식품등,OR=2.927,95％ CI:1.070～8.007,P=0.037),위양방식(내분위양、혼합위양,OR=7.249,95％ CI:2.000～ 26.280,P=0.003;OR=6.220,95％ CI:1.499～ 25.803,P=0.012),자이순수평(OR=8.500,95％CI:2.149～33.618,P=0.002),초진시유방대소(OR=5.325,95％ CI:1.744～ 16.257,P=0.003)여유방조발육영유인적소퇴밀절상관.결론 0～2세영유인유방조발육대다수능구소퇴,대우유방증대불소퇴혹반복출현적환인가능여장기고단백음식、빈번접촉배경내분비간우물유관;지속불소퇴혹퇴이복현적환인응행수방.
Objective To investigate the risk factors associated with premature thelarche in 0 to 2-year-old infants,and analyze the related factors of the regression.Methods A total of 807 infants with premature thelarche,who visited the Department of Endocrinology in Children's Hospital of Jiangxi Province from April 2012 to March 2013,were followed up by two years.Questionnaire survey inquiring information about families,social factors,life-style and diet was repeated and basic levels of serum sex hormones were reassessed.Results In 807 infants with premature thelarche,234 cases lost follow-up and the other 573 cases were followed up successfully.88.8％ (509/573) premature thelarche faded gradually at the average age of 16.6 ± 8.3 months.11.2％ (64/573)had recurrent or persistent thelarche,but only a minority turned into precocious puberty.A multi factor Logistic regression analysis was conducted in 213 infants with returned questionnaires.The related factors of the regression of premature thelarche were families near polluted factories [odd ratio (OR) =5.846,95 ％ CI:1.051-32.521,P =0.044],unharmonious relationship between parents (OR =4.087,95％ CI:1.126-14.839,P =0.032),mothers had an early age of menarche (OR =3.133,95％ CI:1.108-8.859,P =0.031),frequently use of plastic products (bottles,tableware,toys,food packing materials,et al.OR =6.235,95 ％ CI:1.912-20.336,P =0.002),high intake of animal food,high protein diet (OR =3.885,95％ CI:1.452-10.393,P =0.007),high intake of sucker pigmented foods containing preservatives such as fired food,beverage,puffed food (OR =2.927,95％ CI:1.070-8.007,P =0.037),feeding patterns (formula feeding,mixed feeding,OR =7.249,95％ CI:2.000-26.280,P =0.003;OR =6.220,95％ CI:1.499-25.803,P =0.012),estradiol level (OR =8.500,95％ CI:2.149-33.618,P=0.002) and Tanner staging of breast at the first visit (OR =5.325,95％CI:1.744-16.257,P=0.003).Conlusions Premature thelarche fade in mosto to 2-year-dd infants.Unfaded or recurrent cases may relate to long-term consumption of high protein diet,highly frequent contact with environmental endocrine disruptors.For patients with persistent development of breast or recurrent thelarche,a follow up should be performed.
