超声在女童性早熟病因诊断中的价值探讨  

Application value of ultrasound in etiological diagnosis of precocious puberty in girls

作　　者：张娜[1] 孔元原[2] 王连英[1] 

机构地区：[1]首都医科大学附属北京妇产医院北京妇幼保健院保健B超室,北京100026 [2]首都医科大学附属北京妇产医院北京妇幼保健院儿童保健科,北京100026

出　　处：《中国妇幼健康研究》2016年第5期560-563,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨乳腺及盆腔超声在女童性早熟病因诊断中的应用价值。方法收集2014年1月至2015年12月在北京妇产医院儿科经临床确诊为真性性早熟（中央性,CPP）的女童20例为CPP组、单纯乳房早发育（PT）的女童25例为PT组、以及健康女童65例为对照组,对照儿童组（A组）20例（〈8岁）;青春前期组（B组）22例（未初潮,〉8岁）;青春期组（C组）23例（已初潮）,以超声检测子宫、卵巢及乳腺内部回声,结合性早熟及A组女童的雌二醇（E2）、卵泡刺激素（FSH）、黄体生成素（LH）水平,比较其发育情况。结果盆腔超声检查：CPP组子宫宫体/颈比值〉1.2,子宫容积为（2.45±3.08）m L,卵巢容积为（1.57±0.72）m L,卵泡内径为（3.75±2.42）mm,卵泡数目平均为4个,在子宫、卵巢容积及卵泡的数目与大小方面CPP组明显大于PT组、对照A组及B组（t/z=2.434~6.852,均P〈0.05）,PT组与对照A组及B组比较均无显著性差异（均P〉0.05）,CPP组与对照C组比较无显著性差异（P〉0.05）。乳腺超声检查：CPP组与C组女童乳头后方探及盘状中央低回声区及腺体层,周边乳管结构明显,对照A组乳头后方未探及低回声区,PT组及B组乳头后方仅探及盘状中央低回声区,周边乳管结构不明显,腺体未出现。在乳腺中央低回声区范围、腺体回声出现与否,CPP组与PT组、对照B组比较有显著性差异（t=4.648~6.754,均P〈0.05）,CPP组与C组无显著性差异（P〉0.05）,PT组与B组无显著性差异（P〉0.05）。CPP组E2、FSH、LH值明显高于PT组及A组（t=3.923~11.507,均P〈0.01）,PT组E2水平高于对照A组（t=5.554,P〈0.01）,FSH、LH水平均无显著性差异（均P〉0.05）。结论乳头后方探及中央低回声区腺体出现,单侧或双侧卵巢内直径≥4mm,卵泡数目〉4个,卵巢容积〉1.5m L,子宫体容积〉2m L,宫体/颈比值〉1.2,可为超声诊断女童性早熟时的影像表现。Objective To explore the application value of ultrasound examination of mammary gland and pelvic cavity in etiological diagnosis of precocious puberty in girls. Methods A total of 20 girls with central precocious puberty （CPP） were chosen in CPP group, 25 girls with premature thelarche in PT group, and 65 healthy girls in control group. All girls were diagnosed with precocious puberty at the department of pediatrics in Beijing Obstetrics and Gynecology Hospital from January 2014 to December 2015. The control group was subdivided into group A （ n = 20 ; 〈 8 years old）, group B （ n = 22 ; before menophania ; 〉 8 years old ） and group C （ n = 23 ; after menophania）. All these three groups were also called children group, prepuberal group and puberal group, respectively. Ultrasound was used to detect the internal echoes of uterus, ovary and mammary glands. Levels of estradiol （E2 ）, follicle-stimulating hormone （FSH） and luteinizing hormone （LH） were compared between precocious puberty and group A to get to know their development state. Results Pelvic ultrasound results showed that in CPP group corpus uteri/cervix ratio reached 1.2, volume of uterus was 2.45±3.08ml, volume of ovary was 1.57 ± 0.72mL, and inner diameter of follicle was 3.75 ±2.42mm. Besides, the average number of follicle was four. The CPP group exceeded PT group, group A and group B in terms of volume of uterus, ovarian volume, as well as the number and size of follicle （ t/z = 2. 434 - 6. 852, all P 〈 0.05 ）. No significant difference was identified between group A and group B with PT group （ all P 〉 0.05 ）. There was no significant difference between CPP group and group C （ P 〉 0.05 ）. Results of the ultrasound examination of mammary glands were as follows ： discoid central hypoechoic areas and glandular layer were detected at the posterior part of nipple in girls at CPP group and group C. In addition, the structure of mammary vessels in surrounding areas was obvious. No hypoechoic areas were i

关 键 词：超声 性早熟 青春期 病因诊断 

分 类 号：R445[医药卫生—影像医学与核医学] R72[医药卫生—诊断学]