子宫及卵巢超声参数在女童真性性早熟鉴别诊断中的应用价值

Application value of uterine and ovarian ultrasound parameters in the differential diagnosis of true precocious puberty in girls

目的分析子宫及卵巢超声参数在女童真性性早熟鉴别诊断中的应用价值。方法选取2019年4月至2020年4月九江市妇幼保健院确诊的82例性早熟女童患儿作为研究对象,将真性性早熟患儿作为真性组(n=40),假性性早熟患儿作为假性组(n=42);另选取同期于九江市妇幼保健院体检40名正常女童作为对照组。3组均行子宫及卵巢超声,比较3组子宫和卵巢的超声参数,采用单因素及多因素Logistic回归分析真性性早熟的影响因素,绘制ROC曲线分析卵巢超声参数对真性性早熟的诊断价值。结果真性组、假性组子宫容积均大于对照组,子宫横径、子宫纵径及前后径均长于对照组,且真性组子宫容积大于假性组,子宫横径、子宫纵径及前后径均长于假性组,差异有统计学意义(P<0.05)。真性组卵巢容积大于假性组与对照组,卵泡最大直径、卵巢横径、卵巢纵径均长于假性组与对照组,差异有统计学意义(P<0.05);假性组与对照组卵巢容积、卵泡最大直径、卵巢横径、卵巢纵径比较差异无统计学意义。真性组卵巢容积≥2ml、卵泡最大直径≥1cm、卵巢横径≥1 cm、卵巢纵径≥2 cm、子宫容积≥4 ml、子宫横径≥3 cm、子宫纵径≥3 cm、子宫前后径≥2 cm占比均高于假性组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,卵巢容积≥2ml、卵泡最大直径≥1cm、卵巢横径≥1cm、卵巢纵径≥2cm为真性性早熟的独立影响因素(P<0.05)。ROC曲线结果显示,卵巢容积、卵泡最大直径、卵巢横径、卵巢纵径及联合检查诊断真性性早熟的AUC分别为0.914、0.796、0.821、0.876、0.983,均具有较高的诊断价值。结论子宫与卵巢超声参数可明确诊断性早熟,且卵巢超声参数在性早熟分型诊断中应用价值较高。

Objective To analyze the application value of uterine and ovarian ultrasound parameters in the differential diagnosis of true preco-cious puberty in girls.Methods A total of 82 girls with precocious puberty confirmed in Jiujiang Maternal and Child Health Hospital from April 2019 and April 2020 were selected as the research subjects,and they were divided into the true group(n=40)and the false group(n=42),another 40 normal girls who underwent physical examination in Jiujiang Maternal and Child Health Hospital during the same period were selected as the control group.All the three groups underwent uterine and ovarian ultrasound examinations,and the uterine and ovarian ultrasound parameters were com-pared among the three groups,Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of true preco-cious puberty,and ROC curve was drawn to analyze the diagnostic value of ovarian ultrasound parameters for true precocious puberty.Results The uterine volume in the true group and the false group were larger than that in the control group,uterine transverse diameter,uterine longitudinal diame-ter and anteroposterior diameter were longer than those in the control group,the uterine volume in the true group was larger than that in the false group,uterine transverse diameter,uterine longitudinal diameter and anteroposterior diameter were longer than those in the false group,the differenc-es were statistically significant(P<0.05).The ovarian volume in the true group was larger than that in the false group and the control group,the max-imum follicle diameter,ovarian transverse diameter and longitudinal diameter were longer than those in the false group and the control group,the dif-ferences were statistically significant(P<0.05);there was no significant difference in ovarian volume,the maximum follicle diameter,ovarian trans-verse diameter or longitudinal diameter between the false group and the control group.The proportions of ovarian volume≥2 ml,the maximum folli-cle diameter≥1 cm,ovarian transverse diameter≥1 cm,ovarian longitudinal diameter≥2 cm,uterine volume≥4 ml,uterine transverse diameter≥3 cm,uterine longitudinal diameter≥3 cm and uterine anteroposternal diameter≥2 cm in the true group were higher than those in the false group,the differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that Ovarian volume≥2 ml,maxi-mum follicle diameter≥1 cm,transverse diameter≥1 cm and longitudinal diameter≥2 cm were independent influencing factors of true precocious pu-berty(P<0.05).The results of ROC curves analysis showed that the AUC of ovarian volume,maximum follicle diameter,transverse diameter,longi-tudinal diameter of ovary and combined examination in the diagnosis of true precocious puberty were 0.914,0.796,0.821,0.876 and 0.983,respec-tively,all of which had high diagnostic value.Conclusion Uterine and ovarian ultrasound parameters can clearly diagnose precocious puberty clearly,and ovarian ultrasound parameters have higher diagnostic value for the classifications of precocious puberty.