中国循证儿科杂志 ›› 2019, Vol. 14 ›› Issue (1): 40-43.

• 论著 • 上一篇    下一篇

儿童青少年男性乳腺增生的影响因素分析

慎琳1,2,袁珂1,赵方圆1,胡建红3,梁黎1,王春林1   

  1. 1 浙江大学医学院附属第一医院儿科 杭州,310003;2 浙江省诸暨市妇幼保健院 诸暨,311800;3 浙江省诸暨市海亮医院 诸暨,311800
  • 收稿日期:2018-10-11 修回日期:2019-01-10 出版日期:2019-02-25 发布日期:2019-02-25
  • 通讯作者: 王春林

Analysis of the risk factors of gynecomastia in children and adolescents

SHEN Lin1,2, YUAN Ke1, ZHAO Fang-yuan1, HU Jian-hong3, LIANG Li1, WANG Chun-lin1   

  1. 1 Department of Pediatrics, The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China; 2.Maternal and Child Health Hospital of Zhuji, Zhuji 311800, China; 3.Hailiang Hospital of Zhuji, Zhuji 311800, China
  • Received:2018-10-11 Revised:2019-01-10 Online:2019-02-25 Published:2019-02-25
  • Contact: WANG Chun-lin

摘要: 目的 回顾性分析18岁以下儿童青少年男性乳腺增生的临床特征,探讨儿童青少年男性乳腺增生的主要影响因素。方法 病例对照研究。男性乳腺增生组:浙江大学附属第一医院儿科内分泌专科门诊以乳腺增生为主诉就诊且未经药物干预的男生;对照组为体检健康的同年龄男生。分别测量两组身高、体重、BMI,检测血清性激素水平(化学发光免疫分析技术)。结果 男性乳腺增生组298例,年龄3~18(12.4±2.8)岁,乳腺增生于11岁左右达高峰,以后呈现降低趋势,性发育G2和G3期占65.4%。对照组197例,平均年龄(12.1±2.5)岁。两组身高、BMI、睾酮(T)、雌二醇/睾酮(E2/T)、黄体生成素(LH)、黄体生成素/卵泡刺激素(LH/FSH)和催乳素(PRL) 差异均有统计学意义(P均<0.05),体重、年龄、雌二醇(E2)和卵泡刺激素(FSH) 差异无统计学意义(P均>0.05);逐步Logisitic回归分析显示, BMI、T、E2/T、FSH、LH和PRL是男性乳腺增生的危险因素;以上述6项指标作为联合因子敏感度0.748,ROC曲线下面积(AUC)为0.813(95%CI:0.767~0.858)。结论 BMI、T、E2/T、FSH、LH和PRL联合因子对儿童青少年男性乳腺增生有较好的预测价值。

Abstract: Objective The clinical features of gynecomastia in children and adolescents under 18 years old were analyzed retrospectively to explore the main influencing factors of gynecomastia in children and adolescents. Methods This study was a case-control study. The male patients with gynecomastia as the chief complaint and without drug intervention at the department pediatric endocrinology of the First Affiliated Hospital of Zhejiang University were enrolled into the gynecomastia group. The control group consisted of healthy boys of the same age. Height and weight were measured; body mass index (BMI) was calculated; sex hormone levels were detected by chemiluminescence immunoassay. Results The mean age of gynecomastia group (n=298) was (12.4±2.8). Gynecomastia reached its peak around the age of 11, and then showed a decreasing trend. G2 and G3 stage of sexual development accounted for 65.4%. The mean age of the control group (n=197) was (12.1±2.5). Logisitic regression analysis showed that BMI, T, FSH, LH, PRL and E2 / T were the risk factors of the gynecomastia. The sensitivity of the six indicators in combination was 0.748, and the area under the curve (AUC) was 0.813 (95% CI: 0.767-0.858). Conclusion The combination of BMI, T, E2/T, FSH, LH and PRL had a good predictive value for gynecomastia.