血清胰岛素样生长因子1联合子宫与卵巢超声参数对性早熟女童的临床诊断价值

Clinical diagnostic value of serum insulin-like growth factor-1 combined with uterine and ovarian ultrasound parameters for girls with precocious puberty

目的 探讨血清胰岛素样生长因子1(IGF-1)联合子宫与卵巢超声参数对性早熟女童的临床诊断价值。方法 将120例性早熟女童根据病因分为特发性中枢性性早熟(ICPP)组71例和单纯乳房早发育(IPT)组49例,比较两组患儿血清IGF-1水平及子宫与卵巢超声参数,采用Logistic回归分析ICPP影响因素,采用受试者工作特征(ROC)曲线分析血清IGF-1联合子宫与卵巢超声参数对ICPP的诊断价值。结果 ICPP组患儿血清IGF-1水平高于IPT组(P<0.01);ICPP组患儿子宫和卵巢纵径、体积及最大卵泡直径均大于IPT组(P<0.01)。Logistic回归分析结果提示,血清IGF-1水平高,子宫纵径、卵巢纵径、卵巢体积及最大卵泡直径较大均为ICPP的危险因素(P<0.05或0.01);ROC曲线分析结果提示,血清IGF-1水平、子宫纵径、子宫体积、卵巢纵径、卵巢体积及最大卵泡直径对ICPP诊断的曲线下面积(AUC)分别为0.722、0.734、0.713、0.701、0.741及0.656,联合诊断的AUC为0.926。结论 血清IGF-1水平高,子宫纵径、卵巢纵径、卵巢体积及最大卵泡直径较大的女童可能更易发生ICPP,血清IGF-1联合子宫与卵巢超声参数对性早熟女童具有较高的诊断价值。

Objective To explore the clinical diagnostic value of serum insulin-like growth factor-1(IGF-1)combined with uterine and ovarian ultrasound parameters(UOUP)for girls with precocious puberty(PP).Methods A total of 120 PP girls were divided into idiopathic central precocious puberty(ICPP,n=71)and isolated premature thelarche(IPT,n=49)group according to etiology,serum IGF-1 levels and UOUPs compared between two groups,and Logistic regression and receiver operating characteristic(ROC)curve respectively used to analyze the influencing factors of ICPP and the diagnostic value of serum IGF-1 plus the UOUPs in ICPP.Results The serum IGF-1 level was higher in ICPP than IPT group(P<0.01),the longitudinal diameters,volumes and maximum follicle diameters of uterus and ovary were all larger in ICPP than IPT group(P<0.01),Logistic regression analysis showed that high serum IGF-1 level as well as large longitudinal diameters of uterus and ovary,volume of ovary,and maximum follicle diameter were all risk factors of the ICPP(P<0.05 or 0.01),the ROC curve analysis results showed that the area under the curve(AUC)of serum IGF-1 level,uterine longitudinal diameter,uterine volume,ovarian longitudinal diameter,ovarian volume and maximum follicle diameter for the diagnosis of ICPP were respectively 0.722,0.734,0.713,0.701,0.741 and 0.656,the AUC of combined diagnosis was 0.926.Conclusion Girls with high serum IGF-1 level and larger longitudinal diameters of uterus and ovary,ovarian volume and maximum follicle diameter may be more prone to develop the ICPP,serum IGF-1 combined with the UOUPs has higher diagnostic value for PP girls.