摘要
目的检测中枢性性早熟(CPP)女童子宫卵巢发育情况,并探讨其与性激素水平的相关性。方法收集2020年6月—2021年12月于哈尔滨医科大学附属第一医院儿科门诊就诊的59例CPP女童,另选同期同龄31例单纯乳房早发育(PT)女童、38例正常健康女童。分别对3组儿童进行性激素检测[包括雌二醇(E_(2))、睾酮(T)、卵泡刺激素(FSH)、黄体生成素(LH)]及子宫卵巢超声测量,比较各项指标差异情况,并采用Pearson相关性分析法分析各项指标关系。使用ROC曲线得出子宫卵巢超声测值对CPP的最佳截断值。结果CPP女童与健康女童、PT女童相比,身高[(139.03±5.20)cm vs.(129.8±4.89)cm vs.(133.85±6.04)cm]、体质量[(35.14±7.14)kg vs.(27.07±4.06)kg vs.(29.38±5.28)kg]、BMI[(18.08±2.88)kg/m2vs.(16.02±1.72)kg/m2vs.(16.33±2.26)kg/m2]、T[(16.34±9.16)ng/ml vs.(9.48±9.38)ng/ml vs.(11.78±6.08)ng/ml]、FSH[(3.46±1.64)mIU/ml vs.(2.30±1.34)mIU/ml vs.(2.42±1.43)mIU/ml]、LH[(1.11±1.16)mIU/ml vs.(0.17±0.25)mIU/ml vs.(0.40±0.42)mIU/ml]、子宫三径[长径(24.15±5.15)mm vs.(17.98±3.42)mm vs.(19.96±5.16)mm,前后径(13.55±4.32)mm vs.(8.68±2.41)mm vs.(10.28±3.09)mm,横径(18.96±5.16)mm vs.(12.82±4.28)mm vs.(14.59±4.33)mm]、卵巢容积[(2.93±1.59)ml vs.(1.70±1.20)ml vs.(2.17±1.31)ml]均显著升高,差异具有统计学意义(P<0.05);PT女童仅身高[(133.85±6.04)cm]、E_(2)[(19.62±16.17)pg/ml]水平高于健康女童[(129.8±4.89)cm、(10.27±6.52)pg/ml],差异有统计学意义(P<0.05)。Pearson相关分析显示,CPP女童T、E_(2)、LH、FSH与子宫径线呈正相关(P<0.05)。ROC曲线结果提示子宫三径与卵巢容积是诊断CPP的有效指标,最佳诊断截点分别为19.70 mm、9.95 mm、15.30 mm及1.42 ml。结论子宫卵巢超声对于女童CPP具有较高诊断效力,对CPP和PT有一定的鉴别价值。
Objective Uterine and ovarian development in girls with central precocious puberty(CPP)was examined,and exploring the correlation with sex hormone levels.Methods Collecting 59 cases of CPP girls treated in the pediatric clinic of the First Affiliated Hospital of Harbin Medical University from June 2020 to December 2021,and selecting 31 girls with premature thelarche(PT)and 38 normal healthy girls at the same age.Sex hormone testing[including estradiol,testosterone,follicle stimulating hormone(FSH),luteinizing hormone(LH)]and uterine and ovarian ultrasound measurement were conducted in three groups of children,and the differences were compared,and Pearson correlation analysis was used.ROC curves yielded the optimal diagnostic cut-off value for CPP using uterine ovarian ultrasound measurements.Results The height[(139.03±5.20)cm vs.(129.8±4.89)cm vs.(133.85±6.04)cm],weight[(35.14±7.14)kg vs.(27.07±4.06)kg vs.(29.38±5.28)kg],BMI[(18.08±2.88)kg/m^(2) vs.(16.02±1.72)kg/m^(2) vs.(16.33±2.26)kg/m^(2)],testosterone[(16.34±9.16)ng/ml vs.(9.48±9.38)ng/ml vs.(11.78±6.08)ng/ml],FSH[(3.46±1.64)mIU/ml vs.(2.30±1.34)mIU/ml vs.(2.42±1.43)mIU/ml],LH[(1.11±1.16)mIU/ml vs.(0.17±0.25)mIU/ml vs.(0.40±0.42)mIU/ml],uterine diameter[long diameter of the uterus(24.15±5.15)mm vs.(17.98±3.42)mm vs.(19.96±5.16)mm,anterior-posterior diameter of the uterus(13.55±4.32)mm vs.(8.68±2.41)mm vs.(10.28±3.09)mm,transverse diameter of the uterus(18.96±5.16)mm vs.(12.82±4.28)mm vs.(14.59±4.33)mm]and ovarian volume[(2.93±1.59)ml vs.(1.70±1.20)ml vs.(2.17±1.31)ml]of CPP girls were significantly higher than healthy girls and PT girls(P<0.05).Only the height[(133.85±6.04)cm]and estradiol levels[(19.62±16.17)pg/ml]in PT girls were higher than healthy girls[(129.8±4.89)cm,(10.27±6.52)pg/ml],there were statistically significant differences(P<0.05).Pearson correlation analysis showed that,in CPP girls,testosterone,estradiol,LH and FSH was positively associated with the length of uterine diameter.The ROC curve suggested that third diameters of uterine and volume of ovarian are effective indicators for diagnostic CPP,and the optimal cut-off values were 19.70 mm,9.95 mm,15.30 mm and 1.42 ml respectively.Conclusion The uterine ovarian ultrasound has high diagnostic effect for CPP and certain differential significance for CPP and PT.diameters of uterine and volume of ovarian are effective indicators for diagnostic CPP,and the optimal cut-off values were 19.70 mm,9.95 mm,15.30 mm and 1.42 ml respectively.Conclusion The uterine ovarian ultrasound has high diagnostic effect for CPP and certain differential significance for CPP and PT.
作者
张祎俐
孙佳雨
石鸿娇
赵彤
崔岚巍
ZHANG Yi-li;SUN Jia-yu;SHI Hong-jiao;ZHAO Tong;CUI Lan-wei(Department of Pediatrics,The First Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150001,China)
出处
《中国妇幼保健》
2025年第3期440-444,共5页
Maternal and Child Health Care of China
基金
国家重点研发计划重大慢性非传染性疾病防控研究项目(2016YFC1305301)。
关键词
中枢性性早熟
性激素
子宫
卵巢
儿科
Central precocious puberty
Sex hormones
Uterus
Ovary
Pediatrics
