【摘要】：目的:深入了解PAEs暴露對(duì)兒童青少年發(fā)育關(guān)鍵期扮演的角色,基于兒童青少年人群研究的基礎(chǔ)上,分析塑料類(lèi)和化妝類(lèi)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(dòng)時(shí)相階段的相關(guān)關(guān)系,為青春發(fā)動(dòng)時(shí)相提前的機(jī)制和影響因素研究提供基礎(chǔ)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(xué)校作為研究學(xué)校,每所學(xué)校以小班為單位整群抽取。在簽署學(xué)生和家長(zhǎng)知情同意書(shū)的情況下,女生抽取小學(xué)二、三年級(jí)和初一、初二為調(diào)查對(duì)象,男生抽取小學(xué)三、四年級(jí)和初一、初二為調(diào)查對(duì)象,每個(gè)年級(jí)隨機(jī)抽取3~5個(gè)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(shū)的學(xué)生后,對(duì)研究對(duì)象進(jìn)行問(wèn)卷調(diào)查、體格檢查、青春發(fā)動(dòng)重要事件檢查和尿液檢測(cè)。本研究共發(fā)放知情同意書(shū)1642份,同意參加1447人,排除數(shù)據(jù)資料不完整的對(duì)象后,有效問(wèn)卷1286份,參加尿液檢測(cè)923人,安徽醫(yī)科大學(xué)返回有效樣本552份。結(jié)果:本次調(diào)查中研究對(duì)象共有94(7.3%)人處于青春發(fā)動(dòng)時(shí)相提前階段,1192(92.7%)人處于青春發(fā)動(dòng)時(shí)相非提前階段。對(duì)青春發(fā)動(dòng)時(shí)相提前組與非提前組進(jìn)行比較,塑料飯盒的使用情況差異存在統(tǒng)計(jì)學(xué)意義(?2=3.888,P=0.049),但使用塑料類(lèi)產(chǎn)品對(duì)男女童青春發(fā)動(dòng)時(shí)相是否提前并無(wú)明顯作用(P0.05)。護(hù)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(jì)學(xué)意義,且使用護(hù)膚產(chǎn)品對(duì)男女童青春發(fā)動(dòng)時(shí)相提前有明顯的正向作用(OR=1.627,P=0.033),而使用其他幾類(lèi)產(chǎn)品對(duì)男女童青春發(fā)動(dòng)時(shí)相是否提前并無(wú)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(duì)男女童青春發(fā)動(dòng)時(shí)相提前有明顯的正向作用(OR=1.310,P=0.010),而其他幾類(lèi)PAEs代謝物濃度對(duì)男女童青春發(fā)動(dòng)時(shí)相是否提前并無(wú)明顯作用(P0.05)。結(jié)論:針對(duì)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(lèi)和化妝類(lèi)產(chǎn)品的情況以及PAEs代謝物濃度對(duì)青春發(fā)動(dòng)時(shí)相是否提前的相關(guān)關(guān)系,探討其影響的后果及預(yù)防控制措施具有重要意義。我國(guó)應(yīng)結(jié)合國(guó)際社會(huì)對(duì)PAEs有害性的分析結(jié)果,完善兒童接觸日常用品中特定PAEs增塑劑的執(zhí)行標(biāo)準(zhǔn),為解釋環(huán)境因素與內(nèi)分泌代謝之間的關(guān)系,開(kāi)展相關(guān)研究提供預(yù)防干預(yù)策略的科學(xué)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(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R179

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