乳腺、盆腔超声联合血清性激素对女童中枢性性早熟诊断价值的研究  

Study on the diagnostic value of breast and pelvic ultrasound combined with serum sex hormones for central precocious puberty in girls

作　　者：林银萍 余小琴[3] Lin Yinping;Yu Xiaoqin(Medical College of Shangtou University,Shangtou,Guangdong Province,515063,China;The Fourth People's Hospital of Shenzhen LongGang,ShenZhen,Guangdong Province,518000.China;Shengzhen Longgang Central Hospital,ShenZhen,Guangdong Province,518100.China)

机构地区：[1]汕头大学医学院,广东汕头515063 [2]深圳市龙岗区第四人民医院超声科,广东深圳518000 [3]深圳市龙岗中心医院,广东深圳518100

出　　处：《辽宁医学杂志》2024年第4期91-97,共7页Medical Journal of Liaoning

摘　　要：目的本研究旨在探讨乳腺、盆腔超声联合血清性激素:卵泡刺激素(FSH)、黄体生成素(LH)、LH峰值/FSH峰值及雌二醇(E2)等多参数对女童中枢性性早熟诊断价值的研究。方法选取了在2022年1月至2023年12月期间就诊于龙岗中心医院、进行了促性腺激素释放激素(GnRH)激发试验的中枢性性早熟(CPP)(平均年龄(7.00±1.27)岁)65例作为病例组,同时选取了健康女童(平均年龄(6.53±1.11)岁)53例作为对照组。比较两组乳腺超声Tanner分期、子宫体积、卵巢体积、直径大于4mm卵泡个数、平均值、卵泡总体积、卵泡总体积与卵巢体积比以及血清性激素是否具有统计学差异,并测量其ROC曲线下的面积。分析乳腺、盆腔超声联合性激素水平对CPP诊断、探讨多参数联合诊断的准确性、灵敏度和特异度。结果CPP组乳腺超声Tanner(B Tanner)分期的秩均值(65.67)、子宫体积[(2014.56±1355.11)mL]、单侧卵巢体积[(4.55±5.21)mL]、单侧直径大于4mm卵泡平均值[(0.61±0.75)mm]、单侧卵泡总体积[(1.0±2.96)mL]、单侧卵泡总体积与卵巢体积比[0.53±2.48)mL]、FSH[(2.41±1.37)mIU/L]、LH[(0.45±0.98)mIU/L]、LH峰值/FSH峰值[(0.22±0.39)]和E2(53.32)阳性的秩均值均高于对照组B Tanner分期的秩均值(50.66)、子宫体积[(1415.99±799.22)mL]、单侧卵巢体积[(4.55±5.21)mL]、单侧直径大于4mm卵泡平均值[(0.43±0.14)mm]、单侧卵泡总体积[(0.48±0.41)mL]、单侧卵泡总体积与卵巢体积比[0.17±0.11)mL]、FSH[(1.88±0.82)mIU/L]、LH[(2.24±1.37)mIU/L]、LH峰值/FSH峰值[(0.05±0.09)]和E2(38.63)均有统计学意义(P<0.05),而直径大于4mm卵泡个数无统计学差异。由于卵巢有双侧,且卵巢参数较多,使用二元Logistic回归方法得到卵巢多参数回归值,Logistic回归分析显示B Tanner分期、卵巢多参数回归值、FSH是CPP的独立危险因素(P<0.05)。ROC曲线结果显示,B Tanner分期、卵巢多参数回归值、血清性激素联合监测诊Objective The purpose of this study was to investigate the diagnostic value of breast and pelvic ultrasound combined with serum sex hormones such as Follicle Stimulating Hormone(FSH),Luteinizing Hormone(LH),LH peak/FSH peak and Estradiol(E2)in Central Precocious Puberty in girls.Methods A total of 65 patients with Central Precocious Puberty(CPP)(mean age(7.00±1.27)years)who were admitted to Longgang Central Hospital from January 2022 to December 2023 and underwent GnRH stimulation test were selected as a case group.Meanwhile,53 healthy girls(mean age(6.53±1.11)years)were selected as control group.The Tanner stage,uterine volume,ovarian volume,number of follicles with diameter greater than 4mm,average value,total follicle volume,ratio of total follicle volume to ovarian volume,and serum sex hormone were compared between the two groups,and the area under the ROC curve was measured.To analyze the accuracy,sensitivity and specificity of breast and pelvic ultrasound combined with sex hormone levels in the diagnosis of CPP.Results CPP Breast ultrasound Tanner(B Mean rank of Tanner stage(65.67),uterine volume[(2014.56±1355.11)mL],unilateral ovarian volume[(4.55±5.21)mL],mean value of follicles with a diameter greater than 4mm[(0.61±0.75)mm],total volume of unilateral follicles[(1.0±2.96)mL]The mean rank of FSH[(2.41±1.37)mIU/L],LH[(0.45±0.98)mIU/L],LH peak/FSH peak[(0.22±0.39)]and E2(53.32)positive were higher than those in control group B The mean rank of Tanner stage(50.66),uterine volume[(1415.99±799.22)mL],unilateral ovarian volume[(4.55±5.21)mL],mean value of follicles with a diameter greater than 4mm[(0.43±0.14)mm],total volume of unilateral follicles[(0.48±0.41)mL],The ratio of total follicular volume to ovarian volume[0.17±0.11)mL],FSH[(1.88±0.82)mIU/L],LH[(2.24±1.37)mIU/L],LH peak/FSH peak[(0.05±0.09)]and E2(38.63)were statistically significant(P<0.05).There was no significant difference in the number of follicles larger than 4mm in diameter.Due to the bilateral ovary and the large number of ov

关 键 词：中枢性性早熟 乳腺超声Tanner分期 卵巢容积 卵泡刺激素 超声多参数 

分 类 号：R725.8[医药卫生—儿科]