特发性中枢性性早熟与盆腔超声检查及骨龄情况分析

Analysis of idiopathic central precocious puberty and pelvic ultrasound examination as well as bone age

目的探讨盆腔超声检查及骨龄指数(BAI)对特发性中枢性性早熟(ICPP)女童的诊断价值。方法选择我院收治的80例性早熟女童,根据Gn RH激发试验结果,将其分为ICPP组62例和单纯乳房早发育(PT组)18例,对两组行盆腔超声检查、BAI测定,并测定两组血清性激素雌二醇(E2)、卵泡雌激素(FSH)、黄体生成素(LH)水平,以Gn RH激发试验结果作为金标准,分析盆腔超声检查联合血清性激素以及联合BAI测定对ICPP的诊断效能,采用Kappa检验分析与金标准诊断结果的一致性。结果ICPP组患儿的子宫体积和长径、卵巢体积和长径以及最大卵泡直径均大于PT组,差异具有统计学意义(P<0.05);ICPP组BAI为0.25±0.06,PT组为0.08±0.02,差异具有统计学意义(t=11.785,P<0.05);ICPP组E2、FSH、LH水平以及LH/FSH均高于PT组,差异具有统计学意义(P<0.05);盆腔超声检查联合BAI诊断、盆腔超声检查联合激素诊断ICPP诊断效能差异无统计学意义(P>0.05),但二者均具有良好一致性。结论ICPP患儿盆腔超声检查指标及骨龄指数有明显改变,临床可将盆腔超声检查与骨龄指数作为诊断ICPP的重要依据,具有较高的应用价值。

Objective To explore the diagnostic value of pelvic ultrasound examination and bone age index(BAI)in girls with idiopathic central precocious puberty(ICPP).Methods 80 girls with precocious puberty were selected as the research objects.According to the results of Gn RH stimulation test,they were divided into ICPP group(62 cases)and PT group(18 cases)[premature thelarche(PT)].Pelvic ultrasound examination and BAI determination were performed in the two groups,and the levels of serum sex hormones[estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH)]in the two groups were determined.Taking the results of Gn RH stimulation test as the gold standard,the diagnostic efficacy of pelvic ultrasound combined with serum sex hormones and combined with BAI determination for ICPP was analyzed,and the consistency with the gold standard diagnosis was analyzed by Kappa test.Results The uterine volume and long diameter,ovarian volume and long diameter,and the maximum follicle diameter of the ICPP group were larger than those of the PT group,and the number of follicles with a diameter greater than 4 mm were more than those of the PT group,with statistically significant differences(P<0.05).The BAI of the ICPP group was 0.25±0.06,and that of the PT group was 0.08±0.02,with statistically significant differences(t=11.785,P<0.05).The levels of E2,FSH,LH and LH/FSH in the ICPP group were higher than those of the PT group,with statistically significant differences(P<0.05).There was no significant difference in the diagnostic efficacy of pelvic ultrasound combined with BAI and pelvic ultrasound combined with hormone diagnosis of ICPP(P>0.05),but both of them had good consistency.Conclusions The pelvic ultrasound indexes and bone age index of children with ICPP have significant changes.In clinical practice,pelvic ultrasound and bone age index can be used as an important basis for the diagnosis of ICPP,which has high application value.