【摘要】：目的:深入了解PAEs暴露對兒童青少年發(fā)育關鍵期扮演的角色,基于兒童青少年人群研究的基礎上,分析塑料類和化妝類產(chǎn)品的使用情況以及尿液中PAEs代謝物濃度與青春發(fā)動時相階段的相關關系,為青春發(fā)動時相提前的機制和影響因素研究提供基礎和依據(jù)。方法:于2014年11月,采用目的性抽樣的方法,在重慶市九龍坡區(qū)選取兩所九年一貫制學校作為研究學校,每所學校以小班為單位整群抽取。在簽署學生和家長知情同意書的情況下,女生抽取小學二、三年級和初一、初二為調(diào)查對象,男生抽取小學三、四年級和初一、初二為調(diào)查對象,每個年級隨機抽取3~5個班,且男生或女生不少于200人。在排除患有先天性畸形、遺傳、代謝、內(nèi)分泌疾病和未簽署知情同意書的學生后,對研究對象進行問卷調(diào)查、體格檢查、青春發(fā)動重要事件檢查和尿液檢測。本研究共發(fā)放知情同意書1642份,同意參加1447人,排除數(shù)據(jù)資料不完整的對象后,有效問卷1286份,參加尿液檢測923人,安徽醫(yī)科大學返回有效樣本552份。結果:本次調(diào)查中研究對象共有94(7.3%)人處于青春發(fā)動時相提前階段,1192(92.7%)人處于青春發(fā)動時相非提前階段。對青春發(fā)動時相提前組與非提前組進行比較,塑料飯盒的使用情況差異存在統(tǒng)計學意義(?2=3.888,P=0.049),但使用塑料類產(chǎn)品對男女童青春發(fā)動時相是否提前并無明顯作用(P0.05)。護膚產(chǎn)品(?2=4.125,P=0.042)和空氣清新劑(?2=14.512,P=0.000)的使用情況差異存在統(tǒng)計學意義,且使用護膚產(chǎn)品對男女童青春發(fā)動時相提前有明顯的正向作用(OR=1.627,P=0.033),而使用其他幾類產(chǎn)品對男女童青春發(fā)動時相是否提前并無明顯作用(P0.05)。提前組與非提前組尿液中MBP的含量最高,MBz P的含量最低,提前組尿液中MEP的濃度明顯高于非提前組(t=2.417,P=0.016)。PAEs代謝物中MEP的濃度水平對男女童青春發(fā)動時相提前有明顯的正向作用(OR=1.310,P=0.010),而其他幾類PAEs代謝物濃度對男女童青春發(fā)動時相是否提前并無明顯作用(P0.05)。結論:針對兒童青少年普遍暴露于PAEs制品環(huán)境,并根據(jù)其使用塑料類和化妝類產(chǎn)品的情況以及PAEs代謝物濃度對青春發(fā)動時相是否提前的相關關系,探討其影響的后果及預防控制措施具有重要意義。我國應結合國際社會對PAEs有害性的分析結果,完善兒童接觸日常用品中特定PAEs增塑劑的執(zhí)行標準,為解釋環(huán)境因素與內(nèi)分泌代謝之間的關系,開展相關研究提供預防干預策略的科學依據(jù)。
[Abstract]:Objective: to understand the role of PAEs exposure in key developmental stages of children and adolescents, based on the study of children and adolescents. The relationship between the concentration of PAEs metabolites in urine and the phase of youth initiation was analyzed, which provided the basis and basis for the study of the mechanism and influencing factors of the phase of youth initiation. Methods: in November 2014, two nine-year schools in Jiulongpo District of Chongqing were selected as the research schools, and each school was selected in small classes as cluster sampling. Under the condition of signing the informed consent form of the students and parents, the female students selected the second, third and first grade, the second grade of the first grade as the survey objects, and the boys selected the third, the fourth and the first grade, the second grade of the primary school as the objects of investigation, and each grade was randomly selected from 3 to 5 classes. And no less than 200 boys or girls. After exclusion of students with congenital malformations, heredity, metabolism, endocrine diseases and unsigned consent forms, questionnaire survey, physical examination, important events of youth initiation and urine examination were carried out. In this study, 1642 informed consent forms were issued, 1447 people agreed to participate, 1286 valid questionnaires, 923 urine tests, and 552 valid samples returned from Anhui Medical University. Results: a total of 94 (7.3%) subjects were in the early stage of youth initiation, and 1192 (92.7%) were in the phase not in advance. The difference in the use of plastic lunchbox was statistically significant (? 2? 3. 888? P0. 049), but the use of plastic products had no obvious effect on boys and girls when they started their youth (P0.05). There were statistically significant differences in the use of skin care products (? 2 + 4.125) and air fresheners (? 2 (14. 512) P 0. 000). And the use of skin care products for boys and girls youth phase ahead of the obvious positive effect (OR=1.627,P=0.033), and the use of other types of products for boys and girls when the youth phase in advance did not have a significant effect (P0.05). The content of MBP in urine was the highest in the advance group and the lowest in the non-advance group, and the content of, MBz P was the lowest in the urine. The concentration of MEP in urine in the early group was significantly higher than that in the non-advance group (t = 2.417). The concentration of MEP in the metabolite of Pu 0.016 had a significant positive effect (OR=1.310,P=0.010) on the onset of youth for boys and girls, while the concentration of other types of PAEs metabolites had a significant positive effect on the initiation of youth of boys and girls. Whether the phase was in advance had no obvious effect (P0.05). Conclusion: children and adolescents are generally exposed to the environment of PAEs products, and according to their use of plastic and cosmetic products and the concentration of PAEs metabolites in youth initiation phase in advance of the correlation. It is of great significance to discuss the consequences of its influence and the preventive and control measures. In order to explain the relationship between environmental factors and endocrine metabolism, China should improve the implementation standards of specific PAEs plasticizers in children's contact with daily necessities, in accordance with the results of the analysis of the harmfulness of PAEs in the international community, in order to explain the relationship between environmental factors and endocrine metabolism. To carry out relevant research to provide scientific basis for prevention and intervention strategies.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R179

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