本文選題：性早熟 + 肥胖　； 參考：《杭州師范大學(xué)》2017年碩士論文

【摘要】：目的:了解性早熟兒童和正常健康兒童生長發(fā)育水平差異,探討兒童性早熟與生活方式及家族因素的相關(guān)性,并提出預(yù)防兒童性早熟的相關(guān)措施和建議,為有針對性地開展兒童性早熟的防治工作提供科學(xué)依據(jù)。方法:采用病例對照研究方法,按照一定的納入排除標(biāo)準(zhǔn)選取2015年6月—2016年8月在金華市婦保院和杭州師范大學(xué)附屬醫(yī)院小兒內(nèi)分泌科初診并確診為中樞性性早熟的兒童126名作為病例組,按性別年齡成組匹配的正常體檢兒童126名作為對照組,對其進(jìn)行生長發(fā)育狀況的評定和問卷調(diào)查。生長發(fā)育狀況的評定包括體格測量、第二性征評價(jià)、骨齡的測量、性激素基礎(chǔ)值的測定及Gn RH激發(fā)試驗(yàn)等,問卷調(diào)查的主要內(nèi)容包括兒童的一般資料、出生狀況和母孕期狀況、飲食習(xí)慣、生活方式、遺傳因素、社會經(jīng)濟(jì)狀態(tài)、家庭環(huán)境和家長陪伴共七個(gè)方面。采用SPSS20.0處理數(shù)據(jù),用t檢驗(yàn)、c2檢驗(yàn)和秩和檢驗(yàn)進(jìn)行單因素分析,并用二元Logistic回歸篩選出相關(guān)影響因素。結(jié)果:(1)病例組兒童身高、體重、BMI、骨齡均高于對照組,且病例組肥胖檢出率(26.2%)高于對照組(14.3%),差異均具有統(tǒng)計(jì)學(xué)意義(p0.05)。(2)根據(jù)單因素分析的結(jié)果,BMI、是否肥胖、有無午睡習(xí)慣、運(yùn)動時(shí)間、食量大小、母親初潮年齡、家庭親屬中有無性早熟、父親學(xué)歷、母親學(xué)歷、父親職業(yè)、母親職業(yè)、與父親親密程度、父親不在一起時(shí)間、父親陪伴共14個(gè)因素與兒童性早熟有關(guān)聯(lián);二元Logistic回歸分析結(jié)果顯示,不午睡(OR=3.135,p0.001)、食量(OR=1.944,p=0.002)與性早熟呈正相關(guān);母親學(xué)歷(OR=0.576,p=0.004)、母親初潮年齡(OR=0.645,p0.001)、父親陪伴(OR=0.763,p=0.038)與性早熟呈負(fù)相關(guān)。結(jié)論:(1)在同一基線水平下,病例組兒童生長發(fā)育水平暫時(shí)高于對照組。(2)母親初潮年齡早、食量大、父親陪伴少是性早熟的危險(xiǎn)因素,母親學(xué)歷高、有午睡習(xí)慣是性早熟的保護(hù)因素。應(yīng)加強(qiáng)健康知識教育,培養(yǎng)兒童健康的飲食習(xí)慣和生活習(xí)慣,鼓勵家長多陪伴兒童,并完善兒童健康管理服務(wù)流程。
[Abstract]:Objective: to investigate the difference of growth and development level between children with sexual precocious puberty and healthy children, to explore the correlation between precocious puberty and lifestyle and family factors, and to put forward relevant measures and suggestions to prevent precocious puberty in children.To provide scientific basis for the prevention and cure of precocious puberty of children.Methods: a case-control study was conducted.According to certain exclusion criteria, 126 children with central precocious puberty were selected as the case group from June 2015 to August 2016 in the Department of Pediatric Endocrinology of Jinhua Municipal Women's Insurance Hospital and the affiliated Hospital of Hangzhou normal University.126 normal children matched by sex and age were used as control group to evaluate their growth and development status.The evaluation of growth and development includes physical measurement, evaluation of secondary sexual characteristics, measurement of bone age, measurement of basic sex hormone value and GnRH stimulation test, etc. The main contents of the questionnaire include general data of children, birth status and maternal pregnancy status.Eating habits, lifestyle, genetic factors, socioeconomic status, family environment and parental companionship are seven aspects.The data were processed by SPSS20.0, single factor analysis was carried out by t test c2 test and rank sum test, and correlation factors were screened by binary Logistic regression.Results (1) the height, weight and bone age of the children in the case group were higher than those in the control group, and the prevalence rate of obesity in the case group was 26.2) higher than that in the control group. The difference was statistically significant (P < 0.05). 2) according to the results of univariate analysis, BMIs were obese and had the habit of napping.Time of exercise, amount of food, age of mother's menarche, asexual precocious among family relatives, father's education, mother's education, father's occupation, mother's occupation, degree of intimacy with father, father's absence time,The results of binary Logistic regression analysis showed that there was a positive correlation between precocious puberty and sex precocious puberty without napping (3.135%) and eating quantity (1.944%), and a negative correlation between precocious puberty and precocious puberty was found in mother's education (OR 0.576), mother's age at menarche (OR 0.645p 0.001) and father's accompanying ORA (0.763p0. 038).Conclusion: under the same baseline level, the growth and development level of children in the case group was temporarily higher than that in the control group.) the maternal age of menarche was early, the amount of food was large, the father accompanied less was the risk factor of precocious puberty, and the mother had a high degree of education.Having a habit of siesta is a protective factor for precocious puberty.Health knowledge education should be strengthened, healthy eating habits and living habits should be cultivated, parents should be encouraged to accompany their children more, and children health management service flow should be perfected.
【學(xué)位授予單位】：杭州師范大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.8
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本文編號：1767896