黄体生成素基础值联合子宫体积对不同Tanner分期女童中枢性性早熟早期诊断价值的研究

Value of basal luteinizing hormone level combined with uterine volume measurement in the early diagnosis of central precocious puberty in girls with different Tanner stages

目的探讨黄体生成素(luteinizing hormone,LH)基础值联合子宫体积对不同Tanner分期女童中枢性性早熟(central precocious puberty,CPP)早期的诊断价值。方法回顾性分析2017年1月—2022年9月在郑州大学第三附属医院就诊的8岁前出现乳房发育的女童,根据促性腺激素释放激素激发试验结果,将LH峰值≥5.0 IU/L且LH峰值/卵泡刺激素峰值≥0.6纳入阳性组,反之,纳入阴性组。比较两组LH基础值、子宫体积等指标的差异,采用受试者工作特征曲线分析各指标对CPP早期诊断的价值。结果Tanner B2期、B3期女童阳性组的LH基础值、子宫体积均大于阴性组(P<0.05)。Tanner B2、B3期LH基础值诊断CPP的界值分别为0.325 IU/L、0.505 IU/L,子宫体积的界值分别为1.639 mL、2.158 mL;LH基础值联合子宫体积诊断CPP的曲线下面积均高于单用子宫体积(P<0.001),与LH基础值的曲线下面积比较差异无统计学意义(P>0.05)。结论LH基础值联合子宫体积用于不同T anner分期女童CPP的早期诊断有良好的应用价值,为临床诊断提供一定的理论依据与指导意义。

Objective To study the value of basal luteinizing hormone(LH)level combined with uterine volume measurement in the early diagnosis of central precocious puberty(CPP)in girls with different Tanner stages.Methods A retrospective analysis was performed on the girls who presented with breast development before the age of 8 years and attended the Third Affiliated Hospital of Zhengzhou University from January 2017 to September 2022.According to the results of gonadotropin-releasing hormone(GnRH)agonist test,the girls with peak LH≥5.0 IU/L and peak LH/follicle stimulating hormone≥0.6 were enrolled as the positive group,and the other girls were enrolled as the negative group.The two groups were compared in terms of the basal LH level and uterine volume.The receiver operating characteristic(ROC)curve was used to analyze their value in the early diagnosis of CPP.Results For the girls with Tanner B2 and B3 stages,the positive group had significantly higher basal LH level and uterine volume than the negative group(P<0.05).The basal LH level had an optimal cut-off value of 0.325 IU/L and 0.505 IU/L respectively in the diagnosis of Tanner stage B2/B3 CPP,while uterine volume had an optimal cut-off value of 1.639 mL and 2.158 mL respectively.Basal LH level combined with uterine volume measurement had a significantly larger area under the ROC curve than uterine volume measurement alone(P<0.001),but with no significant difference compared with that of basal LH level measurement alone(P>0.05).Conclusions Basal LH level combined with uterine volume measurement is valuable in the early diagnosis of CPP in girls with different Tanner stages,which provides a basis and guiding significance for clinical diagnosis of CPP.