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隐睾症:一项侧重于与中枢神经系统功能障碍关系的流行病学研究。

Cryptorchidism, and epidemiologic study with emphasis on the relationship to central nervous system dysfunction.

作者信息

Depue R H

机构信息

Division of Cancer Etiology, National Cancer Institute, Bethesda, Maryland 20982.

出版信息

Teratology. 1988 Apr;37(4):301-5. doi: 10.1002/tera.1420370403.

Abstract

This case-control study examines the relation of cryptorchidism to central nervous system dysfunction. Elevated odd ratios were found for cerebral palsy (RR = 34), low IQ (RR = 2.7), and low motor function measured by the Bayley test (RR = 3.6). Low IQ and cerebral palsy were independent risk factors for cryptorchidism. Breech labor (RR = 2.6), a gestation less than 34 weeks (RR = 2.0), and being a twin (RR = 4.1) were also independent risks. Other risk factors were estrogen use by the mother (RR = 3.3) and a maternal Quetelet index less than 24 (RR = 1.6). All of these risks were statistically significant. These factors suggest that cryptorchidism may be caused either by sex steroid action directly on the testes or by CNS damage, which in turn causes suppression of pituitary gonadotropins. The increased occurrence of cryptorchidism in twins and small babies indicates that retarded general fetal development can be another mechanism for maldescent of the testes.

摘要

这项病例对照研究探讨了隐睾症与中枢神经系统功能障碍之间的关系。发现脑瘫(相对危险度=34)、低智商(相对危险度=2.7)以及通过贝利测试测得的低运动功能(相对危险度=3.6)的比值比升高。低智商和脑瘫是隐睾症的独立危险因素。臀位分娩(相对危险度=2.6)、孕周小于34周(相对危险度=2.0)以及双胞胎(相对危险度=4.1)也是独立危险因素。其他危险因素包括母亲使用雌激素(相对危险度=3.3)以及母亲的体重指数小于24(相对危险度=1.6)。所有这些风险在统计学上均具有显著性。这些因素表明,隐睾症可能是由性类固醇直接作用于睾丸所致,也可能是由中枢神经系统损伤引起,而中枢神经系统损伤进而导致垂体促性腺激素分泌受抑。双胞胎和小婴儿中隐睾症发生率的增加表明,胎儿整体发育迟缓可能是睾丸下降异常的另一种机制。

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