彩色多普勒超声联合性激素对性早熟女童的诊断价值及其相关性分析

The Diagnostic Value and Correlation Analysis of Color Doppler Ultrasound Combined with Sex Hormone in Girls with Precocious Puberty

目的:探讨彩色多普勒超声联合性激素对性早熟女童的诊断价值及其相关性分析。方法:选择2017年10月至2019年10月我院收治的性早熟女童80例,根据促性腺激素释放激素(GnRH)激发试验结果将其分为中枢性性早熟(CPP)组(n=31),外周性性早熟(PPP)组49例(n=49)。比较两组女童的彩色多普勒超声检查结果及性激素水平,分析卵巢容积、子宫容积与性激素的相关性,并分析子宫容积、卵巢容积及FSH峰值、LH峰值、LH峰值/FSH峰值在性早熟女童中的鉴别诊断价值。结果:CPP组女童卵巢容积、卵泡个数、最大卵泡直径、子宫容积、子宫内膜厚度、乳腺低回声团厚度均显著高于PPP组女童(P<0.05)。CPP组女童促卵泡生成素(FSH)基础值、FSH峰值、促黄体生成素(LH)基础值、LH峰值、LH峰值/FSH峰值均显著高于PPP组女童(P<0.05)。CPP组女童卵巢容积、子宫容积与LH峰值、LH峰值/FSH峰值呈正相关(P<0.05),PPP组女童卵巢容积、子宫容积与性激素水平无相关性(P>0.05),两组LH峰值与LH峰值/FSH峰值均呈正相关(P<0.05)。ROC曲线分析显示,子宫容积、卵巢容积、LH峰值、FSH峰值、LH峰值/FSH峰值鉴别诊断性早熟女童的曲线下面积分别为0.834,0.804,0.753,0.802,0.873。结论:彩色多普勒超声和性激素能够为性早熟女童病情的鉴别提供重要的临床信息,两者结合应用有助于提高性早熟女童的诊断价值。

Objective: To explore the diagnostic value of color Doppler ultrasound combined with sex hormone in girls with precocious puberty. Methods: 80 girls with precocious puberty who were admitted to our hospital from October 2017 to October 2019 were selected, the patients were divided into central precocious puberty(CPP) group(n=31)and 49 cases into peripheral precocious puberty(PPP) group according to gonadotropin releasing hormone(GnRH) stimulation test, the results of color Doppler ultrasound and sex hormone levels of the two groups of girls were compared, analyzed the correlation between ovarian volume, uterine volume and sex hormones and to analyze the early differential diagnosis value of uterine volume, ovarian volume and FSH peak value, LH peak value,LH peak value/FSH peak value in girls with precocious. Results: The ovarian volume, the number of follicles, the diameter of the largest follicle, the volume of uterus, the thickness of endometrium and the thickness of low echo mass of mammary gland in CPP group were significantly higher than those in PPP group(P<0.05). The basic values of Follicle stimulating hormone(FSH), FSH, Luteinizing hormone(LH), LH and LH/FSH in CPP group were significantly higher than those in PPP group(P < 0.05). There was a positive correlation between the ovarian volume, uterine volume and LH peak, LH peak/FSH peak in CPP group(P < 0.05). There was no correlation between the ovarian volume, uterine volume and sex hormone levels in PPP group(P > 0.05). There was a positive correlation between LH peak and LH peak/FSH peak in both groups(P < 0.05). ROC curve analysis showed that the area under the curve of differential diagnosis of girls with precocious puberty by uterus volume, ovary volume, LH peak value, FSH peak value, LH peak value/FSH peak value was 0.834, 0.804, 0.753, 0.802, 0.873 respectively. Conclusion: Color doppler ultrasound and sex hormone can provide important clinical information for girls with precocious puberty and the combination of the two can improve the diagnostic value of girls with precocious puberty.