超声对亮丙瑞林治疗女童性早熟的疗效评估  

Ultrasound evaluation of leuprorelin therapeutic efficacy in girls with central precocious puberty

作　　者：王海荣 陈亚青[1] 许云峰[2] 蒋珺[1] 胡慧勇[2] Wang Hairong;Chen Yaqing;Xu Yunfeng;Jiang Jun;Hu Huiyong(Department of Ultrasound in Medicine,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院超声科,210092 [2]上海交通大学附属儿童医院上海市儿童医院超声科

出　　处：《中华超声影像学杂志》2018年第8期714-719,共6页Chinese Journal of Ultrasonography

摘　　要：目的探讨超声对女童中枢性性早熟药物治疗效果的评估价值。方法40例中枢性性早熟女童均采用亮丙瑞林治疗，在治疗前、治疗3个月后、治疗9个月后分别行子宫卵巢的超声检查及血清促黄体生成素（luteinizing hormone，LH）、促卵泡刺激素（follicle stimulating hormone，FSH）基础水平的测定，并分析子宫、卵巢体积与激素水平变化是否具有相关性。结果亮丙瑞林治疗3个月和9个月后，超声所测子宫卵巢体积均较治疗前明显缩小，差异有统计学意义（均P〈0．05）；LH、FSH水平均较治疗前显著降低，差异有统计学意义（均P〈0．05）。治疗3个月后，卵巢体积缩小率与激素LH、FSH降低率之间呈正相关（r=0．335，P=0．034；r=0．334，P=0．035），子宫体积缩小率与LH、FSH降低率之间无相关性（r=0．110，P=0．501；r=0．257，P=0．109）；治疗9个月后，卵巢体积缩小率与LH、FSH降低率之间呈正相关（r=0．327，P=0．039；r=0．356，P=0．024），子宫体积缩小率与激素LH、FSH降低率之间呈正相关（r=0．439，P=0．005；r=0．433，P=0．005）。结论亮丙瑞林治疗女童中枢性性早熟后能有效抑制激素释放和性腺发育。超声检查可通过动态监测治疗后子宫卵巢的体积变化来直观反映性腺发育情况，并间接了解激素水平变化，且具有无创、简便的优点，可作为中枢性性早熟药物治疗后的常规门诊随访手段。Objective To investigate the value of ultrasound in assessing leuprorelin treatment response of girls with central precocious puberty. Methods Forty girls with central precocious puberty scheduled for leuprorelin treatment were enrolled. Ultrasound examination as well as the serum hormone level test of luteinizing hormone （LH） and follicle stimulating hormone （FSH） were performed prior to the treatment, after 3 and 9 months of treatment. The correlation between uterine volume, ovarian volume and hormone levels were analyzed. Results After 3 and 9 months of leuprorelin treatment, both the volumes of uterus and ovary and the levels of LH and FSH were significant reduced （all P 〈0.05）. After 3 months of leuprorelin treatment, the reduction rate in ovarian volume was positively correlated with the reduction rate of LH andFSH （r =0.335, P =0.034; r =0.334, P =0.035）. No correlation was found between the reduction rate of uterine volume and hormone level changes （ r = 0. 110, P = 0.501; r = 0.257, P = 0. 109）. After 9 months of treatment, the ovarian volume reduction rate was positively correlated with the reduction rate of LH and FSH （r =0.327, P =0.039; r =0.356, P =0.024）,and the uterine volume reduction rate was positively correlated with the reduction rate of LH and FSH （ r = 0. 439, P = 0. 005 ; r = 0.433, P = 0.005 ）. Conclusions Leuprorelin could effectively inhibit hormone release and gonadal development in girls with central precocious puberty. Ultrasound examination, as a noninvasive and convenient method, could dynamically monitor the volume changes of uterus and ovary, thus reflect the development of gonadal development directly and the changes of hormone level indirectly. It could be used as a routine outpatient follow up method after central precocious medicine treatment.

关 键 词：超声检查 中枢性性早熟 女童 药物治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.8[医药卫生—诊断学]