基于GAMLSS探讨重庆地区0～16岁男性阴茎及睾丸生长发育研究

发布时间：2018-03-03 23:39

本文选题：重庆地区　切入点：阴茎长度　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的本文通过研究0~16岁男性阴茎、睾丸发育情况,探讨构建重庆地区0~16岁男性阴茎长度、阴茎直径、双侧睾丸大小的生长发育参考范围,绘制不同年龄男性阴茎长度、阴茎直径、双侧睾丸大小生长发育的百分位数曲线,为临床疾病的诊断和治疗提供重要依据。方法通过分层整群抽样,对2607位正常男性儿童青少年进行阴茎、睾丸测量调查。采用SPSS 22.0统计软件进行数据特征描述,计量资料以中位数P50表示,各年龄组阴茎长度、直径和睾丸体积的比较采用非参数检验中的Kruskal-Walliis H检验,P0.05表示差异有统计学意义。广义可加模型采用R软件中的基于位置、尺度、形状的广义可加模型(GAMLSS)软件包进行参考曲线拟合。了解重庆地区阴茎、睾丸的数据特点,采用广义可加模型(GAMLSS)拟合模型,初步探讨重庆市0~16岁儿童青少年阴茎大小和睾丸体积的P3、P10、P25、P50、P75、P90、P97的百分位数曲线。结果1.重庆地区儿童青少年阴茎的生长发育现状调查对象结果表2.1及表2.3显示,本研究共计16个年龄分组,共纳入2607例,0~16岁年龄组各个年龄组总体用秩和检验Kruskal-Walliis H检验差异有统计学意义(P0.01),Kruskal-Walliis H检验中成对两两比较得出:0岁组和1岁组两组的阴茎长度比较差异有统计学意义(P0.01),发育增长速度最快,为44.60%(图),达到整个生长发育的增长高峰,Kruskal-Walliis H检验中成对两两比较1~11岁相邻两组的阴茎长度比较差异无统计学意义(P0.05);11~16岁相邻两组的阴茎长度比较差异有统计学意义(P0.01)由百分位数图2.1得出1岁以前阴茎长度增长快速,1~11岁组间增长较缓慢,11岁进入快速增长期,一直持续到16岁。阴茎直径结果显示,0~16岁年龄组用阴茎直径各个年龄组总体用秩和检验Kruskal-Walliis H检验差异有统计学意义(P0.01),两两比较得出:0岁组和1岁两组的阴茎直径比较差异有统计学意义(P0.01),组内两两比较1~11岁相邻两组的阴茎直径差异无统计学意义(P0.05);11~16岁相邻两组的阴茎直径比较差异有统计学意义(P0.01),由百分位数图2.3得出1岁以前阴茎长直径增长快速,1~11岁组间增长较缓慢,11岁进入快速增长期,一直持续到16岁。阴茎长度和阴茎直径发展一致,同步进入青春期。2.重庆地区睾丸生长发育现状调查对象结果显示(表2.4),0岁到1岁调查对象102例,各个年龄组左右两侧睾丸体积总体用秩和检验Kruskal-Walliis H检验以及两组成对比较来进行组间两两比较(P0.01),进行组内两两比较,结果显示0岁组右侧睾丸体积与1岁比较差异有统计学意义(P0.05),;1~10岁组间增长较缓慢,相邻两组差异无统计学意义(P0.05);10~16岁差异有统计学意义(P0.01),百分位数图(图2.5和图2.7)其中10岁进入快速增长期,15岁后增长速度减慢。左侧睾丸结果显示与右侧睾丸结果几乎一致,3.睾丸与阴茎的关系Spearman秩相关检验结果显示(表2.7),阴茎长度、阴茎直径与睾丸大小的生长发育互为正相关,阴茎长度与阴茎直径的Spearman秩相关系数为0.93(r=0.93,P0.01);阴茎长度与右侧睾丸体积的Spearman秩相关系数为0.89(r=0.89,P0.01),;阴茎长度与左侧睾丸体积的Spearman秩相关系数为0.89(r=0.89,P0.01);阴茎直径与右侧睾丸体积的Spearman秩相关系数为0.83(r=0.83,P0.01);阴茎直径与左侧睾丸体积的Spearman秩相关系数为0.83(r=0.83,P0.01);左、右侧睾丸体积的Spearman秩相关系数是0.99(r=0.99,P0.01)。。结论阴茎长度及睾丸体积大小是衡量男性儿童性发育的重要指标,与男性性功能和生育功能存在密切联系。因此对其正确,因地制宜的研究非常重要。重庆地区0~16岁的男性儿童青少年阴茎长度、阴茎直径、与年龄三者互为正相关,同时本研究首次将WHO所推荐的用于儿童生长发育的GAMLSS方法运用到男性阴茎、睾丸的生长发育方面,得到了重庆地区男性儿童不同年龄组阴茎长度、直径,左右侧睾丸体积生长发育情况的不同百分位数值,绘制了以年龄为协变量的精确百分位数曲线图,有利于临床医生更早期发现阴茎疾病,丰富、扩展了对重庆地区青春期性器官发育研究,为学校卫生相关内容的研究提供了科学依据,为后期更深入的运用GAMLSS模型提供了前期的基础。
[Abstract]:The purpose of this study by 0~16 year old male penis, testis development, construction of Chongqing area 0~16 year old male penis penis length, diameter, growth and development of the reference range of bilateral testicular size, drawn in different age male penis penis length, diameter, percentile size of bilateral testicular growth and development, provide an important basis for clinical diagnosis and treatment disease. Methods by stratified cluster sampling, the penis of 2607 normal male children and adolescents, testis survey data features are described. Using SPSS 22 statistical software, measurement data with median P50 said that in each age group compared with the penis length, diameter and volume of testis Kruskal-Walliis H test nonparametric test. P0.05 said the difference was statistically significant. The generalized additive model based on the location and scale of R software, the shape of the generalized additive model (GAMLSS) software Package reference curve fitting. In the Chongqing region of the penis, testis data characteristics, using generalized additive models (GAMLSS) model, preliminary study of Chongqing city 0~16 year old children and adolescents penis size and testicular volume of P3, P10, P25, P50, P75, P90, P97 percentile curve. The results of growth the development of 1. respondents in Chongqing children's penis in Table 2.1 and Table 2.3 shows the results of this study, a total of 16 age groups, a total of 2607 cases, there was statistical significance in 0~16 age group in all age groups with rank sum test and Kruskal-Walliis H test (P0.01, Kruskal-Walliis) the difference in H test compared with 22 pairs statistical significance at the age of 0 and 1 years old group of penis length difference between two groups (P0.01), the development of the fastest growth rate, 44.60% (Figure), the growth of high growth, Kruskal-Walliis H test in 22 pairs 1~11 at the age of two adjacent penis length was no significant difference (P0.05); there was statistical significance of penis length 11~16 years old two adjacent group differences (P0.01) by percentile of figure 2.1 that 1 years ago the rapid growth of the penis length, the age group of 1~11 between the relatively slow growth of 11 years, entered a period of rapid growth until the age of 16. The diameter of the results showed that the 0~16 age group with the diameter of each age group in general with the rank sum test Kruskal-Walliis H tests were statistically significant (P0.01), 22 compared with statistical significance at the age of 0 1 years group and two groups of penis (P0.01), the difference was not statistically significant the diameter of the differences among groups compared to 22 1~11 years old two adjacent group (P0.05); there was statistical significance between the two groups of adjacent 11~16 (P0.01), the diameter of the difference by percentile of figure 2.3 that 1 years before the penis length diameter rapid growth The 1~11 age group, among the relatively slow growth of 11 years, entered a period of rapid growth, until 16 years old. The length and diameter of the penis penis development, synchronous puberty in Chongqing area.2. survey results showed that the growth status of the testis (Table 2.4), 0 to 1 years old 102 subjects of different age groups on both sides the overall volume of testis with rank sum test Kruskal-Walliis H test and two for comparison comparison between the 22 groups (P0.01), were compared in 22 groups. Results showed that there was a statistically significant 0 year old and 1 year old group right testicular volume difference (P0.05), 1~10; age group between the relatively slow growth, no significant difference two groups of adjacent (P0.05); 10~16 was statistically significant differences in age (P0.01), percentile chart (Figure 2.5 and figure 2.7) in which 10 year old entered a period of rapid growth, the growth rate slowed down after 15 years. The results showed that the left testis and right testis results almost Consistent relationship between Spearman rank correlation test results of 3. testis and penis showed (table 2.7), penis, penis and testis size growth are positive correlation, Spearman rank correlation coefficient of penis length and diameter of penis was 0.93 (r=0.93, P0.01); Spearman rank correlation coefficient of penis length and right testis volume 0.89 (r=0.89, P0.01), Spearman rank correlation coefficient; penis length and left testicular volume was 0.89 (r=0.89, P0.01); Spearman rank correlation coefficient and diameter of the right testis volume was 0.83 (r=0.83, P0.01); Spearman rank correlation coefficient and diameter of the left testicular volume was 0.83 (r=0.83, P0.01 left, 0.99); Spearman rank correlation coefficient of right testis volume (r=0.99, P0.01). Conclusion the penis length and testicular volume is an important measure of male sexual development of children, there are close and male sexual function and reproductive function Contact. So the correct, very important to the study of Chongqing area. The 0~16 year old male adolescent penis, penis, and age three are positive correlation, at the same time, this study is the first to recommend WHO GAMLSS method for the growth of children with growth and development of male penis, testis, get the male children in Chongqing area in different age groups of penis length, diameter, different percentile side testicular volume growth, plotted with age as covariate precise percentile curves, help clinicians more early detection of disease of penis, rich, extends the study on the development of adolescent sexual organs in Chongqing area the research provides a scientific basis for school health related content, provides the basis for the use of early late more in-depth GAMLSS model.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R179

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