超声对中枢性性早熟女童的辅助诊断及药物治疗的疗效观察

Ultrasonography in diagnosing central precocious puberty of girls and clinical effect of drug therapy

目的探讨超声检查在女童中枢性性早熟的辅助诊断及药物治疗的疗效评价。方法对28例中枢性性早熟患儿进行促性腺激素释放激素类似物(GnRHa)治疗,应用超声检测治疗前、治疗后3个月、治疗后6个月的子宫、卵巢大小及形态学变化,并与28例正常同龄女童的子宫、卵巢进行对比,予以促性腺激素释放激素(GnRH)激发试验采用化学发光法测定血清黄体生成素(LH)和卵泡刺激素(FSH)。结果中枢性性早熟女童治疗前的子宫容积、卵巢容积、卵泡直径、LH值、FSH值均大于正常女童,差异均有统计学意义(t分别=6.24、14.40、7.41、10.43、8.56,P均<0.05)。中枢性早熟女童治疗前、GnRHa治疗后3个月与6个月子宫、卵巢容积、卵泡直径、LH值、FSH值差异均有统计学意义(F分别=19.93、18.89、30.18、52.31、41.07,P均<0.05)。经LSD-t检验两两比较发现:与治疗前相比,治疗3个月和治疗6个月子宫容积、卵巢容积、卵泡直径、LH值、FSH值均下降,差异均有统计学意义(t分别=-8.32、-19.65、-7.89、-26.78、-9.61;-12.13、-9.31、-11.67、-30.15、-12.08,P均<0.05);治疗6个月与3个月相比,子宫容积、卵巢容积、卵泡直径减小,差异均有统计学意义(t分别=-5.32、-8.65、-6.89,P均<0.05);在GnRHa治疗6个月后子宫容积、卵巢容积与正常女童差异均有统计学意义(t分别=7.65、5.05,P均<0.05)。结论超声检查对中枢性性早熟女童的检出率高,对其治疗后的临床疗效的评价及疗效随访具有实用价值。

Objective To investigate the value of uhrasonography in diagnosing central precocious puberty of girls and curative effect of drug therapy. Methods Twenty eight cases of central precocious puberty were treated with gonadotropin releasing hormore analogues （GnRHa）. The uterine and ovarian morphologie changes were monitored with ultrasound before treatment, 3 months and 6 months after treatment. Then compared with the noruaal control group. Serum luteinizing hor- mone （LH） and follicule-stimulating hormone （FSH） were measured by chemoluminescence. Results The uterine volumes, ovarian volumes, the size and the numbers of follieles,LH,FSH of the cases with central precocious puberty were significantly larger than those of the normal control group （t=6.24,14.40,7.41,10.43,8.56,P〈0.05） . The differeces of uterine and ovarian volumes, the size and the numbers of follicles,LH,FSH among before treatment, 3 months and 6 months after GnRHa treatment were statistically significant （F=19.93,18.89,30.18,52.31,41.07,P〈0.05）. After 3 months and 6 months treatment, the uterine volumes, ovarian volumes, the size of follicles, LH, FSH of the cases with central precocious puberty were significantly smaller than that before treatment （t=-8.32, -19.65, -7.89, -26.78, -9.61 ; -12.13, -9.31, -11.67, -30.15,12.08 ,P〈0.05）. Compared with 3 months treatment and after 6 months treatment, the uterine volumes, ovarian volumes and the size of follicles of the cases with central precocious puberty were significantly smaller（t=-5.32, -8.65,-6.89,P〈0.05）. After 6 months GnRHa treatment , the uterine and ovarian volumes were statistically significant compared with those of the normal girls（t=7.65,5.05 ,P〈0.05）. Conclusions Ultrasonography has great value on diagnosing central precocious puberty and evaluating its clinical effects.