發(fā)布時(shí)間：2018-01-10 11:13

  本文關(guān)鍵詞：雙酚A與女童單純?nèi)榉吭绨l(fā)育及中樞性性早熟關(guān)系的臨床觀察研究　出處：《蘇州大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 雙酚A 單純?nèi)榉吭绨l(fā)育 中樞性性早熟 Kisspeptin 性激素

【摘要】：研究背景近些年來兒童青春發(fā)育呈現(xiàn)出提前發(fā)育的趨勢，性早熟受到越來越多人的關(guān)注。性早熟的病因很多，目前認(rèn)為環(huán)境內(nèi)分泌干擾物（Environmentalendocrine-disrupting chemicals,EDCs）是引起性早熟的原因之一。文獻(xiàn)報(bào)道雙酚A（BisphenolA，BPA）作為環(huán)境內(nèi)分泌干擾物的一種，能干擾正常的內(nèi)分泌活動(dòng)，動(dòng)物實(shí)驗(yàn)中發(fā)現(xiàn)新生鼠長期低劑量BPA的暴露會(huì)引起性發(fā)育提前，雌性更加敏感。但迄今為止BPA對2歲以下女童單純?nèi)榉堪l(fā)育（Permature Thelarche,PT）的影響及BPA在6-8歲女童單純?nèi)榉堪l(fā)育及中樞性性早熟（Central precocious puberty,CPP）中的影響報(bào)道甚少，仍然不清楚其對2歲以下女童乳房發(fā)育及中樞性性早熟有無影響，而且BPA在下丘腦或其他組織中可能通過何種途徑作用于靶細(xì)胞的機(jī)制并不明確。 研究目的從臨床角度觀察研究BPA對2歲以下女童單純?nèi)榉堪l(fā)育的影響及探討B(tài)PA在6-8歲女童單純?nèi)榉堪l(fā)育及中樞性性早熟中的關(guān)系，并探討其可能的機(jī)制及原因。 研究方法1.選擇內(nèi)分泌門診就診的6月---2歲PT40例，選擇同期6月--2歲無乳房發(fā)育女童32例作為對照組，測量身高體重，詢問喂養(yǎng)情況，利用高效液相色譜串聯(lián)質(zhì)譜法（HPLC-MS-MS）進(jìn)行血清BPA濃度測定，利用化學(xué)發(fā)光法進(jìn)行兩組血清性激素濃度測定，比較兩組差異及分析BPA與性激素之間相關(guān)性。 2.選擇我院內(nèi)分泌門診就診的6-8歲性早熟女童，平均根據(jù)性早熟的診斷標(biāo)準(zhǔn)及分類標(biāo)準(zhǔn)將性早熟女童分為CPP組47例及PT組56例，選擇同期6-8歲無青春發(fā)育的女童53例作為對照組，測量身高體重，利用HPLC-MS-MS方法測定各組BPA濃度，用化學(xué)發(fā)光法進(jìn)行PT組及CPP組性激素水平測定，用酶聯(lián)免疫吸附法測定各組血清Kisspeptin濃度，比較三組差異、分析BPA與性激素、Kisspeptin之間相關(guān)性。 研究結(jié)果1.6月---2歲女童PT組血清BPA檢出率67.5%，濃度13.95±1.187ng/ml,高于正常對照組血清BPA檢出率30.9%,濃度8.036±0.548ng/ml，，兩組有統(tǒng)計(jì)學(xué)意義（P0.05）。兩組血清卵泡刺激素（Follicle-stimulating hormone, FSH）,泌乳素（Prolactin,PRL）濃度無統(tǒng)計(jì)學(xué)差異(P0.05)，乳房發(fā)育組E2檢出率（50%）高于正常對照組（18.75%）（P0.05），乳房發(fā)育組黃體生成素（Luteotrophic hormone,LH）檢出率（47.5%）高于正常對照組（0.00）（P0.001）。兩組BPA濃度與FSH濃度無相關(guān)性（r=0.179)、兩組BPA濃度與PRL濃度也無相關(guān)性（r=0.279），BPA濃度與E2和LH有相關(guān)性（P0.05）。 2．6-8歲CPP組BPA的檢出率95.83%，BPA濃度31.94±7.302ng/ml,PT組BPA檢出率82.14%,濃度15.57±1.426ng/ml，正常對照組BPA檢出率58.5%,濃度9.912±0.736ng/ml, CPP組BPA檢出率及BPA濃度高于PT組（P 0.05）及正常對照組（P 0.01），PT組BPA檢出率高于正常對照組，BPA濃度與正常對照組比較無統(tǒng)計(jì)學(xué)差異，（P0.05）。CPP組Kisspeptin濃度327.2±30.11pg/ml高于PT組224.2±19.81pg/m（lP 0.01）及正常對照組244.2±17.47pg/m（lP 0.05），PT組Kisspeptin濃度與正常對照組比較無統(tǒng)計(jì)學(xué)差異，（P0.05）。CPP組雌二醇（Estradiol,E2）濃度37.69±3.508pg/ml，高于PT組E2濃度27.44±2.002pg/ml,(P 0.01)。BPA濃度與Kisspeptin、LH、FSH濃度無相關(guān)性(P0.05)，BPA濃度與E2濃度有正相關(guān)性(P0.05)。 研究結(jié)論.6月--2歲女童存在BPA的暴露。BPA暴露可能是6月--2歲女童出現(xiàn)乳房發(fā)育的原因之一。6月--2歲女童BPA的暴露可能影響LH及E2的分泌。6-8歲女童性早熟的發(fā)生與BPA的暴露有關(guān)，BPA的暴露可能是中樞性性早熟的原因之一。6-8歲性早熟女童BPA的暴露可能使E2的分泌增加，但與LH、FSH濃度無線性相關(guān)。BPA可能并非通過影響Kisspeptin蛋白表達(dá)來導(dǎo)致血清E2的升高從而對性早熟產(chǎn)生影響。
[Abstract]:Background in recent years shows early puberty development in children with precocious puberty development trend, attracted more and more attention. The cause of precocious puberty, the environmental endocrine disruptors (Environmentalendocrine-disrupting chemicals EDCs) is one of the reasons causing precocious puberty. Reports of bisphenol A (BisphenolA, BPA) as a kind of environmental endocrine disruptors that can interfere with normal endocrine activity, animal experiments found that exposure of neonatal rats with long-term low dose BPA can cause early puberty, female is more sensitive. But so far the BPA on the 2 girls under the age of pure breast development (Permature Thelarche, PT) and the effect of BPA in the 6-8 year old girl pure breast development and central precocious puberty (Central precocious puberty, CPP) the effect of report is very little, still not clear on the 2 girls under the age of breast development and there is no central precocious puberty The mechanism of BPA in the hypothalamus or other tissues that may act on the target cells is not clear.
The purpose of this study is to observe the effect of BPA on the development of breast in girls under 2 years old, and to explore the relationship between BPA and simple breast development and central precocious puberty in 6-8 year old girls.
Methods 1. selected endocrine clinic in June ---2 years PT40 cases, select the same period of June --2 years without breast development in girls in 32 cases as control group, measurement of height and weight, about feeding, using high performance liquid chromatography tandem mass spectrometry (HPLC-MS-MS) for determination of serum BPA concentration, luminescence serum sex hormone levels in two groups were measured the use of chemical analysis, the difference between the two groups and between BPA and sex hormone dependence.
2. select the endocrine clinic in our hospital 6-8 year old girls with precocious puberty, precocious girls average will be divided into 47 cases of group CPP and group PT 56 cases according to the diagnostic criteria of sexual precocity and classification standard, select the same period in 6-8 years without puberty girls in 53 cases as control group, height and weight were measured, using the HPLC-MS-MS method for the determination of the determination of BPA concentration, PT group and CPP group of sex hormone levels by chemiluminescence method, determination of serum Kisspeptin concentration by enzyme-linked immunosorbent assay, the difference between the three groups, analysis of BPA and Kisspeptin. The correlation between sex hormones.
Results 1.6 months ---2 year old girl group PT serum BPA positive rate was 67.5%, the concentration of 1.187ng/ml + 13.95, higher than the normal control group serum BPA positive rate was 30.9%, the concentration of 8.036 + 0.548ng/ml, two groups have statistical significance (P0.05). Serum follicle stimulating hormone (Follicle-stimulating group two hormone, FSH), prolactin (Prolactin, PRL) there was no significant difference in the concentration (P0.05), breast development group E2 positive rate (50%) higher than the normal control group (18.75%) (P0.05), breast development group of luteinizing hormone (Luteotrophic hormone, LH) detection rate (47.5%) and Gao Yuzheng (0) normal control group (P0.001). There was no correlation between BPA concentration and FSH concentration of two group (r=0.179), BPA concentration and PRL concentration of two groups have no correlation (r=0.279), the concentration of BPA is correlated with E2 and LH (P0.05).
2.6-8 CPP group BPA positive rate was 95.83%, the concentration of BPA 31.94 + 7.302ng/ml PT group, BPA positive rate was 82.14%, the concentration of 15.57 + 1.426ng/ml, the control group BPA positive rate was 58.5%, the concentration of 0.736ng/ml 9.912 + CPP group, the detection rate of BPA and BPA were higher in PT group (P 0.05) and normal control group (P 0.01) in group PT, the detection rate of BPA is higher than the normal control group, no significant differences between the BPA concentration and the normal control group, group.CPP (P0.05) concentration of Kisspeptin 327.2 + 30.11pg/ml 224.2 + 19.81pg/m higher than that of group PT (lP 0.01) and normal control group 244.2 + 17.47pg/m (lP 0.05), there was no statistical difference between PT group and normal Kisspeptin concentration the control group (P0.05),.CPP group (Estradiol, E2) estradiol concentration was 37.69 + 3.508pg/ml, E2 concentration higher than 27.44 in group PT + 2.002pg/ml (P, 0.01).BPA concentration and Kisspeptin, LH, there is no correlation between the concentration of FSH (P0.05), there was a positive correlation between BPA concentration and E2 concentration (P0.05).
Conclusions.6 month --2 year old girl BPA exposure to.BPA exposure may be June --2 year old girl appeared breast development one of the reasons for.6 months --2 years old girl BPA exposure may influence the secretion of E2 and LH.6-8 year old girls with precocious puberty associated with BPA exposure, BPA exposure may be exposed to central precocious puberty one of the reasons why.6-8 year old girls with precocious puberty BPA may make the secretion of E2 increased, but the concentration of FSH and LH, there was no correlation between the.BPA may not lead to the increase of serum E2 of precocious effect by influencing the expression of Kisspeptin protein.

【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R725.8

【參考文獻(xiàn)】

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1 王應(yīng)e

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