血清AMH和子宫附件B超参数在女童快进展型中枢性性早熟的早期预警价值

Early Warning Value of Serum AMH and Uterine Adnexal Ultrasound Pa⁃rameters in Fast Progressive Central Precocious Puberty in Girls

目的分析血清抗苗勒管激素(anti-Müllerian hormone,AMH)和子宫附件B超参数在女童快进展型中枢性性早熟的早期预警价值。方法非随机选取2022年6月—2024年6月汕头大学医学院附属粤北人民医院收治的60例中枢性性早熟(central precocious puberty,CPP)女童为研究对象,根据是否出现快速进展的指标分为慢进展型中枢性性早熟(SP-CPP)组和快进展型中枢性性早熟(RP-CPP)组,各30例,选择同期30名健康体检女童为对照组。所有女童均进行血清AMH和子宫附件B超检测,统计并分析3组女童的临床指标以及早期预警价值。结果SP-CPP组与RP-CPP组的血清AMH(3.79±1.24)ng/mL、(2.63±0.31)ng/mL低于对照组的(5.30±1.50)ng/mL,差异有统计学意义(F=41.540,P<0.05)。RP-CPP组的血清AMH相较于SP-CPP组更低,差异有统计学意义(P<0.05)。SP-CPP组与RP-CPP组的横径数据比较,差异无统计学意义(P>0.05)。SP-CPP组的纵径、前后径、子宫体积均低于RP-CPP组,差异有统计学意义(P均<0.05)。SP-CPP组与RPCPP组的卵巢超声参数相较对照组更高,且RP-CPP组高于SP-CPP组,差异有统计学意义(P均<0.05)。子宫体积早期预警女童快进展型CPP的AUC为0.789。结论AMH和子宫附件B超参数对女童快进展型中枢性性早熟具有一定的早期预警价值,且子宫体积的预警价值最高。

Objective To analyze the value of serum anti-Mullerian hormone(AMH)and adnexal B ultrasound param-eters in early warning of rapidly progressing central precocious puberty in girls.Methods Sixty cases of central preco-cious puberty(CPP)girls admitted to the North Guangdong People's Hospital of Shantou University Medical School from June 2022 to June 2024 were non-randomly selected as the study objects.According to the indicators of rapid progression,they were divided into slow progressive central precocious puberty(SP-CPP)group and fast progressive central precocious puberty(RP-CPP)group,with thirty cases each,and thirty healthy girls in the same period were se-lected as control group.All girls underwent serum AMH and uterine adnexal B ultrasound detection,and the clinical indicators and early warning value of the three groups of girls were statistically analyzed.Results Serum AMH(3.79±1.24)ng/mL and(2.63±0.31)ng/mL in SP-CPP group and RP-CPP group were lower than those in control group(5.30±1.50)ng/mL,and the difference was statistically significant(F=41.540,P<0.05).Serum AMH in RP-CPP group was lower than that in SP-CPP group,and the difference was statistically significant(P<0.05).There was no signifi-cant difference in transverse diameter between SP-CPP group and RP-CPP group(P>0.05).The longitudinal diam-eter,anteroposternal diameter and uterine volume of SP-CPP group were lower than those of RP-CPP group,and the differences were statistically significant(all P<0.05).The ultrasonic parameters of ovary in SP-CPP group and RP-CPP group were higher than those in control group,and the RP-CPP group were higher than SP-CPP group,the differ-ences were statistically significant(all P<0.05).The AUC for early warning of rapid progression of CPP in girls with uterine volume was 0.789.Conclusion AMH and uterine annex B ultrasound parameters have certain early warning value for girls with rapid progression of central precocious puberty,and uterine volume has the highest early warning value.