盆腔超声在GnRHa治疗女童特发性中枢性性早熟中的临床应用

目的 探讨应用盆腔超声监测特发性中枢性性早熟女童经促性腺激素释放激素类似物（GnRHa）治疗前后的子宫卵巢结构参数变化特点及其临床应用价值.方法 2012年3月至2015年1月期间,对47例临床确诊为特发性中枢性性早熟女童（性早熟组）进行GnRHa治疗,于治疗前后均应用盆腔超声进行子宫卵巢结构参数测量,并运用免疫化学发光法进行性激素水平的测定.同期对55例健康正常性发育女童（正常组）进行盆腔超声检查并测量子宫卵巢结构参数作对比分析.结果 性早熟组的子宫体积、卵泡最大径、卵巢体积均较正常组明显增大（P〈0.05）;与治疗前比较,性早熟组女童经GnRHa治疗后的子宫体积、卵泡最大径、卵巢体积均出现明显减小（P〈0.05）;与治疗前比较,性早熟组女童经GnRHa治疗后的促黄体生成素峰值,促卵泡素峰值以及雌二醇水平均出现明显下降（P〈0.05）.结论 盆腔超声能客观准确无创性地诊断特发性中枢性性早熟,并可实时动态监测评估GnRHa对患儿的临床治疗效果,为临床诊断治疗提供参考依据.

Objective To explore the uterine ovarian structure parameters characteristics and clinical value of pelvic ultrasound in monitoring idiopathic central precocious puberty（ICPP）girls before and after treatment by gonadotropin-releasing hormone agonist（GnRHa）. Methods During March 2012 to January 2015,47 cases of girls with ICPP（precocious puberty group）were treated by GnRHa. Before and after treatment,pelvic ultrasound were applied to measure the uterus ovarian structure parameters,and measured the sex hormone levels by the immune chemiluminescence method. Over the same period,55 cases of normal sexual development girls（normal group）were measured the uterus ovarian structure parameters by pelvic ultrasound for comparative analysis. Results The uterine volume,follicle maximum diameter and ovarian volume in precocious puberty group were obviously increased than that in the normal group（P〈0.05）. Compared with before treatment,the uterine volume, follicle maximum diameter and ovarian volume were obviously reduced in precocious puberty girls after treatment with GnRHa（P〈0.05）. Compared with before treatment,the peak of luteinizing hormone,follicle stimulating hormone and the estradiol level were significantly lower in precocious puberty girls after treatment with GnRHa（P〈0.05）. Conclusions Pelvic ultrasound can objectively accurately noninvasively diagnosis of ICPP,and real-time dynamic monitor and evaluate for the clinical curative effect after treatment by GnRHa,provide reference basis for clinical treatment.