新生儿肛门生殖器距离及其影响因素研究

发布时间：2018-05-28 08:14

本文选题：肛门生殖器距离 + 新生儿　；参考：《广州医科大学》2017年硕士论文

【摘要】：背景:肛门生殖器距离(AGD)是反映人类性发育的重要指标,目前学者主要将AGD应用于临床来衡量雄性化、评估孕期宫内雄激素暴露水平、研究与隐睾及尿道下裂的关系、评估成年男性生殖能力等。但是国内对AGD的研究不多,尚未见单独有关新生儿AGD测量的报告。目的:建立足月新生儿AGD的正常参考值,并对可能影响新生儿AGD的因素进行探讨,为进一步研究AGD与性发育的关系提供参考。方法:选取在2017年3月至2017年4月期间出生于广州医科大学附属第三医院的正常足月新生儿,共205例,其中男性116例,女性89例。所有新生儿均在出生后72h内进行测量,测量工具采取数显游标卡尺。男性新生儿AGD采用3个测量指标,分别为:肛门中心至阴囊基底部的距离(ASD);肛门中心至阴茎基底背侧的距离(AGD1);肛门中心至阴茎基底腹侧的距离(AGD2)。女性新生儿AGD采用2个测量指标,分别为:肛门中心至阴唇后联合的距离(AFD);肛门中心至阴蒂的距离(ACD)。每个指标测量两次,取平均值,测量值精确到0.1mm。结果:1.男性足月新生儿AGD值分别为:ASD:20.6±2.9mm;AGD1:45.7±3.8mm;AGD2:40.0±4.4mm。女性足月新生儿AGD值分别为:AFD:12.5±2.3mm;ACD:35.5±2.1mm。2.不同性别足月新生儿AGD值比较,男性ASD(20.6±2.9mm)大于女性AFD(12.5±2.3mm),男性AGD1(45.7±3.8mm)、AGD2(40.0±4.4mm)均大于女性ACD(35.5±2.1mm),P均0.01,具有显著统计学意义。3.单胎新生儿AGD与双胎新生儿AGD比较,男性单胎新生儿ASD、AGD1、AGD2均大于双胎新生儿,分别为20.7±2.9mm VS 18.4±2.0mm、46.0±3.7mm VS 42.4±1.8mm、40.3±4.4mm VS 36.4±2.7mm,P均0.05,差异具有统计学意义;女性单胎新生儿AFD、ACD均大于双胎新生儿,分别为12.6±2.2mm VS 10.7±1.2mm、35.6±2.0mm VS 33.9±1.7mm,P均0.05,差异具有统计学意义。4.Pearson相关分析结果显示:胎龄与ASD(r=0.212,P0.050)、AGD1(r=0.276,P0.05)、AGD2(r=0.169,P0.05)、AFD(r=0.270,P0.05)及ACD(r=0.273,P0.05)均呈正相关。出生体重与ASD(r=0.232,P0.05)、AGD1(r=0.433,P0.05)、AGD2(r=0.320,P0.05)、AFD(r=0.288,P0.05)、ACD(r=0.516,P0.05)均呈正相关。出生身长与ASD(r=0.162,P0.05)、AGD1(r=0.324,P0.05)、AGD2(r=0.300,P0.05)、AFD(r=0.246,P0.05)、ACD(r=0.424,P0.05)均呈正相关。5.不同分娩方式及各种母亲因素(包括受孕年龄、孕前体重、产前体重、孕期增重、产妇身高、孕前BMI、孕次、产次)与新生儿AGD均无相关性。6.多元逐步回归分析显示:出生体重可能是新生儿AGD重要的影响因素(βASD=0.232、βAGD1=0.433、βAGD2=0.320、βAFD=0.288、βACD=0.516;P均0.05)。结论:本研究共测量了205例正常足月新生儿,获得了足月新生儿肛门生殖器距离的正常参考值。结果显示男性新生儿AGD大于女性新生儿AGD,证实AGD具有性别二态性。同时发现单胎新生儿AGD大于双胎新生儿AGD,胎龄、出生体重、出生身长与新生儿AGD呈正相关,其中出生体重可能是新生儿AGD重要的影响因素。本研究的测量方法简单、可靠,可重复性强,易于推广应用,具有较大临床意义。
[Abstract]:Background: anal genitalia distance (AGD) is an important indicator of human sexual development. At present, AGD is mainly used to measure malinization, to assess the level of intrauterine androgen exposure during pregnancy, and to study the relationship with cryptorchidism and hypospadias. To evaluate the reproductive ability of adult males. However, there are few studies on AGD in China, and there is no separate report on neonatal AGD measurement. Objective: to establish the normal reference value of AGD in term neonates and to explore the possible factors affecting neonatal AGD so as to provide reference for further study of the relationship between AGD and sexual development. Methods: 205 normal term newborns were selected from March 2017 to April 2017 in the third affiliated Hospital of Guangzhou Medical University, including 116 males and 89 females. All newborns were measured within 72 hours after birth with digital Vernier calipers. The AGD of male newborns was measured by three indexes: the distance from the anal center to the base of the scrotum, the distance from the anal center to the dorsal side of the penile base, and the distance between the anal center and the ventral base of the penis, and the distance between the anal center and the ventral base of the penis. The AGD of female newborns was measured by two indexes: the distance from the anal center to the posterior labia and the distance from the anal center to the clitoris. Each index is measured twice, with an average value of 0.1 mm. The result is 1: 1. The AGD values of male full-term newborns were 20. 6 卤2. 9 mm: 1: 45.7 卤3. 8 mm and 40. 0 卤4. 4 mm. respectively. The AGD values of female full-term newborns were 12. 5 卤2. 3 mm and 35. 5 卤2. 1 mm. The AGD values of male and female full-term neonates were higher than that of female AFD(12.5 卤2.3mm and 40.0 卤4.4mm of AGD1(45.7 卤3.8mm respectively, which were significantly higher than that of female's ACD(35.5 卤2.1mm (P < 0.01). Compared with AGD of twin neonates, AGD of single born male neonates were higher than those of twin neonates (20.7 卤2.9mm vs 18.4 卤2.0 mm vs 46.0 卤3.7mm vs 42.4 卤1.8 mm vs 40.3 卤4.4mm vs 36.4 卤2.7 mm P, P < 0.05). The difference was statistically significant (P < 0.05). The results of Pearson correlation analysis showed that the gestational age was positively correlated with the gestational age and the age of ACD 0.212p 0.050 AFDR 0.276P0.05AFDR 0.270P0.05). There was a positive correlation between birth weight and ASD ru 0.232 (P 0.05), AGD1 (0.433), AGD2 (0.320) (P0.05), AFDR (0.288), ACDT (0.516), P0.05 (P 0.05), and ACDD _ (1) P _ (0.05) (P _ (0.05) P _ (0. 05) P _ (0.05) P _ (0.05). There was a positive correlation between the length of the birth and the ASD ru 0.162 P0.05 AGD1 / ACD1 / P0.05 / ACDD _ (0.24) / P _ (0.05) P _ (0.300) ~ (0.300) / AFDR ~ (0.246) / P ~ (0.05) ~ (0.24) / P ~ (0.05) / ACDD ~ (0.24) / P ~ (0.05) / ACDD ~ (0.24) / P ~ (0.05). There was no correlation between maternal factors (including conception age, weight before pregnancy, prenatal weight, weight gain during pregnancy, height of puerpera, BMI before pregnancy, first time of pregnancy, times of delivery) and neonatal AGD. Multiple stepwise regression analysis showed that birth weight may be an important influencing factor of neonatal AGD (尾 ASD: 0.232, 尾 AGD1: 0.433, 尾 AGD2: 0.320, 尾 AFDN: 0.288, 尾 ACDD: 0.516, P = 0.05). Conclusion: 205 normal term newborns were measured in this study, and the normal reference value of anal genital distance of term newborns was obtained. The results showed that the AGD of male newborns was higher than that of female neonates, which confirmed that AGD had gender dimorphism. At the same time, it was found that the AGD of single born neonates was higher than that of twin neonates, gestational age, birth weight and length of birth were positively correlated with neonatal AGD, among which birth weight may be an important influencing factor of neonatal AGD. The method is simple, reliable, reproducible and easy to be popularized and applied.
【学位授予单位】：广州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R722.1

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