Page 80 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第11期
·1572 · Journal of Nanjing Medical University（Natural Sciences） 2022年11月

·临床研究·

晨尿联合盆腔超声及血清基础促性腺激素水平在女童中枢性

性早熟初步诊断中的应用

许媛媛 ，王 婕 ，汤勇泉 ，朱艳丽 ，汤爱梅 ，谷 奇 ，谭 娟 ，李月娥 ，周文娣 1*
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南京医科大学附属淮安第一医院儿科，江苏 淮安 223300；徐州医科大学淮安临床学院儿科，江苏 淮安 223300
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［摘 要］ 目的：探讨晨尿联合盆腔超声及血清基础促性腺激素（gonadotropin，Gn）水平检测在女童中枢性性早熟（central pre⁃
cocious puberty，CPP）初步诊断中的意义。方法：以就诊于南京医科大学附属淮安第一医院的83例性早熟女童为研究对象，收
集年龄、骨龄、盆腔超声、血清基础Gn等资料，对可疑CPP女童行促性腺激素释放激素（gonadotropin⁃releasing hormone，GnRH）
激发试验，根据结果分为CPP组和非CPP组。同期留取所有病例晨尿3 mL，测定Gn水平。采用SPSS 25.0软件对数据进行统
计分析，并绘制受试者工作特征（receiver operating characteristic，ROC）曲线。结果：①CPP 组晨尿黄体生成素（luteinzing hor⁃
mone，LH）、卵泡刺激素（follicle⁃stimulating hormone，FSH）显著高于非CPP 组，差异有统计学意义（P < 0.05）。②晨尿LH与血
清LH峰值、子宫容积、卵巢容积呈正相关（P均< 0.001）；晨尿LH/FSH比值与血清LH/FSH峰值比、子宫容积、卵巢容积呈正相
关（P均< 0.001）。③用于诊断CPP的晨尿LH、子宫容积的ROC曲线下面积（area under curve，AUC）、界值、灵敏度和特异度分
别为0.879、2.12 U/L、82.1%、88.0%；0.935、1.87 cm 、87.2%、88.0%；血清基础LH≥0.3 U/L诊断CPP的灵敏度为89.7%，特异度为
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80.0%。④晨尿LH、血基础LH及子宫容积联合诊断CPP时，AUC、灵敏度和特异度分别为0.977、92.3%、96.0%，均高于单一指
标。结论：晨尿LH、血清基础LH联合子宫容积可作为女童CPP 初步筛查指标，且无创、便捷，可进一步提高CPP 初步诊断效
能，具有一定的临床应用价值。
［关键词］ 尿促性腺激素；盆腔超声；性早熟；女童；诊断

［中图分类号］ R725.9 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）11⁃1572⁃06
doi：10.7655/NYDXBNS20221111

Application of morning urine combined with pelvic ultrasound and serum gonadotropin
levels in the primary diagnosis of girls with central precocious puberty

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XU Yuanyuan ，WANG Jie ，TANG Yongquan ，ZHU Yanli ，TANG Aimei ，GU Qi ，TAN Juan ，LI Yue’e ，ZHOU
Wendi 1*
1 Department of Pediatrics，the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University，Huai’an
223300；Department of Pediatrics，Huaian Clinical College of Xuzhou Medical University，Huai’an 223300，China
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［Abstract］ Objective：This study aims to investigate the diagnostic value of morning urine combined with pelvic ultrasound and
serum basal urinary gonadotropin（Gn）levels of girls with central precocious puberty（CPP）. Methods：Total 83 girls with precocious
puberty attending our hospital were enrolled in this study. The age，bone age，the uterus ultrasonic，basal serum Gn levels and other
related informations were collected. For girls with suspected CPP，gonadotropin ⁃ releasing hormone（GnRH）stimulation test was
performed. Then 83 girls were divided into CPP group and non⁃CPP group according to the results of GnRH test. At the same time，
morning urine from all patients were also collected. Then，the Gn levels were detected by immunochemiluminometric assays. SPSS 25.0
software was used for statistical analysis of the data，and receiver operating characteristic curve（ROC）was drawn. Results：①The
levels of luteinzing hormone（LH）and follicle⁃stimulating hormone（FSH）of morning urine in CPP group were significantly higher than
those in non⁃CPP group（P < 0.05）. ②The LH levels in morning urinary were positively correlated with peak LH levels in the serum，
uterine volume and ovarian volume（P < 0.001）；urinary LH/FSH ratios were also positively correlated with peak LH/FSH ratios in the

［基金项目］ 江苏省妇幼保健协会项目（FYX202213）
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通信作者（Corresponding author），E⁃mail：hayyzhwd@njmu.edu.cn