[1]杨玉 石乔.0～2岁婴幼儿乳房早发育的临床随访研究[J].国际内分泌代谢杂志,2015,(05):309-313.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.05.006]
　Yang Yu,Shi Qiao.A clinical follow up study of premature thelarche in 0 to 2-year-old infants[J].International Journal of Endocrinology and Metabolism,2015,(05):309-313.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.05.006]
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0～2岁婴幼儿乳房早发育的临床随访研究()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
期数:
2015年05期
页码:
309-313
栏目:
论著
出版日期:
2015-09-20

文章信息/Info

Title:
A clinical follow up study of premature thelarche in 0 to 2-year-old infants
作者:
杨玉 石乔
330006 南昌,江西省儿童医院内分泌遗传代谢科
Author(s):
Yang Yu; Shi Qiao
Department of Endocrine Genetic Metabolic,Children's Hospital of Jiangxi Province,Nanchang 330006, China
关键词:
乳房早发育;  婴幼儿;  随访;  危险因素
Keywords:
Premature thelarche;  Infant;  Follow-up;  Risk factor
DOI:
DOI:10.3760/cma.j.issn.1673-4157.2015.05.006
摘要:
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。
Abstract:
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.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:江西省科技厅支撑计划项目(20121BBG70043) 作者单位:330006 南昌,江西省儿童医院内分泌遗传代谢科
更新日期/Last Update: 2015-09-20