乳腺及子宫卵巢彩超检查联合血清性激素对性早熟女童的诊断价值

Diagnostic value of color Doppler ultrasound examination of breast, uterus and ovary combined with serum sex hormones in girls with precocious puberty

目的探讨乳腺及子宫卵巢彩超检查联合血清性激素对性早熟女童的诊断价值。方法选取2018年1月至2022年2月于新余市人民医院检查就诊的106例性早熟女童作为研究对象,根据促性腺激素释放激素(GnRH)激发试验结果,将女童分为特发性中枢性性早熟(ICPP)组(n=58)和单纯乳房早发育(PT)组(n=48)。所有女童均接受乳腺及子宫卵巢彩超检查和血清性激素水平检测,比较分析两组女童的乳腺及子宫卵巢超声指标、血清性激素水平,并采用受试者工作特征曲线(ROC)分析超声指标、血清性激素水平联合诊断ICPP的诊断效能。结果ICPP组女童的乳腺低回声团厚度、最大卵泡直径、子宫体积、卵巢体积均大于PT组,差异有统计学意义(P<0.05)。ICPP组女童的血清黄体生成激素(LH)、雌二醇(E_(2))、卵泡刺激素(FSH)水平均高于PT组,差异有统计学意义(P<0.05)。ROC分析结果显示,超声联合血清性激素联合诊断的敏感度、特异度、曲线下面积、约登指数均高于各指标单一检测。结论乳腺及子宫卵巢彩超检查、血清性激素水平检测对ICPP均具有一定的诊断价值,两者联合使用可以进一步提升诊断效能,乳腺及子宫卵巢彩超检查可以作为ICPP诊断的辅助手段。

Objective To explore the diagnostic value of color Doppler ultrasound examination of breast,uterus and ovary combined with serum sex hormones in girls with precocious puberty.Methods A total of 106 girls with precocious puberty who were examined and treated in Xinyu People's Hospital from January 2018 to February 2022 were selected as the research objects.According to the results of gonadotropin releasing hormone(GnRH)provocation test,the selected girls were divided into idiopathic central precocious puberty(ICPP)group(n=58)and simple premature thelarche(PT)group(n=48).All girls received breast,uterus and ovary color Doppler ultrasonography and serum sex hormone levels.The ultrasonic indexes and serum sex hormone levels of mammary gland,uterus and ovary of girls in the two groups were compared and analyzed,and the diagnostic efficacy of ultrasonic indexes and serum sex hormone levels in the joint diagnosis of ICPP was analyzed by using the receiver operating characteristic curve(ROC).Results The breast hypoechoic mass thickness,maximum follicular diameter,uterine volume and ovarian volume of girls in ICPP group were greater than those in PT group,and the differences were statistically significant(P<0.05).The serum luteinizing hormone(LH),estradiol(E_(2)),follicle stimulating hormone(FSH)levels of girls in ICPP group were higher than those in PT group,with statistically significant differences(P<0.05).ROC analysis showed that the sensitivity,specificity,area under the curve and Jordan indexes of ultrasound combined with serum sex hormone were higher than those of single detection.Conclusion Color ultrasound examination of breast,uterus and ovary and detection of serum sex hormone levels have certain diagnostic value for ICPP.The combined use of the two can further improve the diagnostic efficiency.Color Doppler ultrasound examination of breast,uterus and ovary can be used as an auxiliary means of ICPP diagnosis.