多普勒子宫动脉成像和盆腔超声辅助晨尿促性腺激素水平诊断女童中枢性性早熟
作者:
作者单位:

作者简介:

通讯作者:

中图分类号:

R179

基金项目:

江苏省妇幼保健协会科研项目(FYX202213)


Diagnosis of central precocious puberty in girls with Doppler uterine artery imaging and pelvic ultrasound assisted by morning urinary gonadotropin level
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:探讨多普勒子宫动脉成像、盆腔超声辅助晨尿促性腺激素水平在初诊女童中枢性性早熟(central precocious puberty,CPP)中的应用价值。方法:选取2022年4月—2023年5月就诊于徐州医科大学淮安临床学院儿科的96例性早熟女童为研究对象,收集患儿一般资料,检测血基础黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle stimulating hormone, FSH)、雌二醇水平,收集晨尿测定LH和FSH水平,检测骨龄,同时进行盆腔多普勒彩超检查评估子宫动脉搏动指数(pulse index, PI)和子宫长径、横径、前后径,计算子宫容积和卵巢容积等。行促性腺激素释放激素(gonadotropin-releasing hormone,GnRH) 激发试验,依据激发实验结果将女童分为非CPP组和CPP组。运用统计软件对相关数据进行分析。结果:①CPP组患儿子宫动脉PI显著低于非CPP组,子宫长径、晨尿LH均显著高于非CPP组(P < 0.05);②相关性分析结果表明,子宫动脉PI与晨尿 LH、晨尿 FSH、子宫长径、横径、前后径、子宫容积、卵巢容积、血 LH 峰值呈负相关(P < 0.05),与血 FSH 峰值无显著相关 (P > 0.05);子宫长径与晨尿LH、晨尿FSH、子宫横径、前后径、子宫容积、卵巢容积以及血LH峰值均呈正相关(P < 0.05),与血 FSH峰值无显著相关(P > 0.05);晨尿LH水平与晨尿FSH、子宫长径、横径、前后径、子宫容积、卵巢容积以及血LH峰值、FSH 峰值均呈正相关(P < 0.05);③ROC曲线分析子宫动脉PI、子宫长径、晨尿LH诊断女童CPP的曲线下面积(area under curve, AUC)、灵敏度和特异度分别为 0.915、76%、90%,0.945、95%、88%,0.925、91%、84%,而子宫动脉PI、子宫长径、晨尿LH联合诊断女童CPP时,其AUC、灵敏度、特异度分别为0.974、98%、90%,优于单一指标。结论:子宫动脉PI、子宫长径及晨尿LH联合诊断女童CPP效能最高,且具有安全、无创、便捷等优点,适合临床推广应用。

    Abstract:

    Objective:To investigate the application value of Doppler uterine artery imaging and pelvic ultrasound combined with morning urine gonadotropin in the preliminary diagnosis of central precocious puberty(CPP)in girls. Methods:A total of 96 precocious girls admitted to the Department of Pediatrics,Huai’an Clinical College,Xuzhou Medical University from April 2022 to May 2023 were recruited as the study objects. General data were collected,serum basic luteinizing hormone(LH),follicle stimulating hormone(FSH),and estradiol levels were examined,morning urine LH and FSH were determined,and bone age was detected. At the same time,pelvic Doppler ultrasonography was performed to evaluate the uterine artery pulse index(PI),long diameter,transverse diameter and anteroposterior diameter of uterine,uterine volume,and ovarian volume. The girls were divided into the non-CPP group and the CPP group according to the results of GnRH stimulation test. Statistical software was used to analyze and integrate relevant data. Results:①The level of the uterine artery PI in the CPP group was significantly lower than that in the non -CPP group,while uterine long diameter as well as the level of morning urine LH in the CPP group were significantly higher than those in the non-CPP group(P < 0.05). ②Correlation analysis showed that uterine artery PI was negatively correlated with morning urine LH,morning urine FSH,long diameter,transverse diameter,anteroposterior diameter of uterine,uterine volume,ovarian volume,and serum LH peak value (P < 0.05),but had no significant correlation with serum FSH peak value(P > 0.05). Uterine long diameter was positively correlated with morning urine LH,morning urine FSH,uterine transverse diameter,anteroposterior diameter,uterine volume,ovarian volume,and serum LH peak value(P < 0.05),but had no significant correlation with serum FSH peak value(P > 0.05). Morning urine LH level was positively correlated with morning urine FSH,uterine long diameter,transverse diameter,anteroposterior diameter,uterine volume, ovarian volume,serum LH peak and FSH peak(P < 0.05). ③The area under curve(AUC),sensitivity and specificity of ROC curve when uterine artery PI,uterine long diameter,and morning urine LH were used for diagnosing CPP in girls were 0.915,76%,90%; 0.945,95% ,88% ;0.925,91% ,84% ,respectively. When uterine artery PI,uterine long diameter,and morning urine LH were combined in the diagnosis of CPP in girls,the AUC,sensitivity and specificity were 0.974,98% and 90%,respectively,which was better than used alone. Conclusion:The combined determination of uterine artery PI,uterine long diameter and morning urine LH display the highest efficacy in the diagnosis of CPP in girls,and has the advantages of safety,non -invasive and convenient,which is suitable for clinical application.

    参考文献
    相似文献
    引证文献
引用本文

李月娥,汤涌泉,杨明明,谷奇,高钱,周文娣.多普勒子宫动脉成像和盆腔超声辅助晨尿促性腺激素水平诊断女童中枢性性早熟[J].南京医科大学学报(自然科学版),2023,(10):1385-1391

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2023-07-02
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2023-10-23
  • 出版日期:
通知关闭
郑重声明