卵巢、乳腺超声检查与骨龄指数联合评估在诊断女童中枢性性早熟中的应用价值

Application value of ovarian and breast ultrasonography combined with bone age index in the diagnosis of central precocious puberty in girls

目的:研究卵巢、乳腺超声检查与骨龄指数联合评估在诊断女童中枢性性早熟(CPP)中的应用价值。方法:选取2020年11月至2021年11月中山市博爱医院收治的80例CPP女童作为观察组,另将同期在该院进行健康体检的女童80例作为对照组。两组女童均予以促性腺激素释放激素(GnRH)激发试验,同时行卵巢、乳腺超声检查与骨龄指数测定。比较两组女童的血清性激素水平、超声检查指标、乳腺超声分级、骨龄及骨龄指数,并以GnRH激发试验结果为依据,观察卵巢、乳腺超声检查联合骨龄指数诊断女童CPP的价值。结果:观察组女童血清雌二醇(E_(2))、促卵泡激素(FSH)、促黄体生成素(LH)的水平均高于对照组女童,差异有统计学意义(P<0.05)。观察组女童的子宫容积、卵巢容积、卵巢长径、卵巢前后径、卵巢横径、最大卵泡直径、乳腺低回声团厚度、乳房体积均大于对照组女童,卵泡个数多于对照组女童,差异有统计学意义(P<0.05)。观察组女童的乳腺超声分级、骨龄指数和骨龄均高于对照组女童,差异有统计学意义(P<0.05)。卵巢、乳腺超声检查联合骨龄指数测定诊断女童CPP的灵敏度、特异度、阳性检出率及阴性检出率均高于卵巢、乳腺超声检查或骨龄指数测定(P<0.05)。结论:卵巢、乳腺超声检查与骨龄指数联合评估可用于诊断女童CPP,临床应用价值较高。

Objective:To study the application value of ovarian and breast ultrasonography combined with bone age index in the diagnosis of central precocious puberty(CPP)in girls.Methods:A total of 80 girls with CPP admitted to Zhongshan Boai Hospital from November 2020 to November 2021 were selected as the observation group,and another 80 girls who underwent physical examination in the hospital during the same period were selected as the control group.Gonadotropin-releasing hormone(GnRH)stimulation test,ovarian and breast ultrasonography and bone age index were performed in both groups.The serum sex hormone levels,ultrasound examination indexes,breast ultrasound grading,bone age and bone age index were compared between the two groups.Based on the results of GnRH challenge test,the value of ovarian and breast ultrasound combined with bone age index in the diagnosis of CPP in girls was observed.Results:The levels of serum estradiol(E 2),follicle stimulating hormone(FSH)and luteinizing hormone(LH)in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The uterine volume,ovarian volume,ovarian length diameter,anteroposterial diameter,transverse diameter,maximum follicle diameter,breast hypoechoic mass thickness and breast volume of girls in the observation group were larger than those in the control group,and the number of follicles was more than that in the control group,and the differences were statistically significant(P<0.05).The breast ultrasound grade,bone age index and bone age of girls in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The sensitivity,specificity,positive detection rate and negative detection rate of ovarian and breast ultrasound combined with bone age index in the diagnosis of CPP in girls were higher than those of ovarian and breast ultrasound or bone age index(P<0.05).Conclusion:The combined evaluation of ovarian and breast ultrasonography and bone age index can be used to diagnose CPP in girls,which has high clinical application value.