子宫卵巢超声结合Z-score方法对女性性早熟的诊断价值

摘要
图/表
参考文献(21)
相关文章 (15)

全文: PDF (931 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的分析子宫卵巢超声结合Z-score方法在女性性早熟中的诊断价值。方法选取2017年2月—2020年2月广东省东莞市第八人民医院（以下简称“我院”)收治的207例3~8岁女性性早熟患儿为实验组，另选取同期在我院咨询身高或体检的3~8岁健康儿童112名为对照组。根据性早熟部位分为单纯乳房过早发育（PT）及阴毛早生（PP）亚组50例、外周性性早熟（PPP）亚组61例、中枢性性早熟（CPP）亚组96例。两组均接受子宫、卵巢超声检测以获取子宫体、双侧卵巢径线，并计算体积；建立Z-score模型，计算Z值；受试者工作特征曲线（ROC）用于女性性早熟的诊断效能。结果年龄与卵巢体积、子宫体长径相关性最大（r = 0.82、0.95，P ＜ 0.05）。PPP患儿子宫体长径平均Z值为2.59±2.29（-2.70，6.00），曲线下面积为0.909，最佳诊断临界值为1.05，敏感度为97.99%，特异性为81.90%。CPP患儿巢体积平均Z值为7.49±7.49（-0.48，36.99），曲线下面积为0.939，最佳诊断临界值为2.15，敏感度为100.00%，特异性为80.90%；宫体长径平均Z值为4.59±4.19（-1.15，22.79），曲线下面积为0.839，最佳诊断临界值为1.13，敏感度为90.80%，特异性为85.10%。结论子宫卵巢超声结合Z-score方法能有效诊断PPP、CPP，对儿童至青春期女性性早熟的诊断有重要作用，值得临床推广。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	仲先玲1 张国强2▲ 蒋双兰1 易全英1 卜秋强1 余凤1

关键词 ：子宫, 卵巢, 超声, Z-score方法, 女性, 性早熟

Abstract：Objective To analyze the diagnostic value of uterine and ovarian ultrasound combined with Z-score method in female precocious puberty. Methods A total of 207 female with precocious puberty who aged three to eight years old from February 2017 to February 2020 in Dongguan Eighth People′s Hospital of Guangdong Province （hereinafter referred to as “our hospital”） were the experimental group. In addition, 112 healthy children aged three to eight years old who consulted height or physical examination in our hospital during the same period were selected as the control group. According to the location of precocious puberty, 50 cases were simple preature thelarhe (PT) and premature pubarche (PP) subgroup, 61 cases were peripheral precocious puberty (PPP) subgroup, and 96 cases were central precocious puberty (CPP) subgroup. Ultrasound examination of uterin and ovarin was performed in both groups to obtain uterine body and bilateral ovarian diameter lines, and the volume was calculated, the Z-score model was established and the Z value was calculated. Receiver operating characteristic (ROC) curve was used for the diagnosis of precocious puberty in female. Results Age had the greatest correlation with ovarian volume and uterine body length diameter (r = 0.82, 0.95, P < 0.05). The average Z value of uterine body length diameter with PPP children was 2.59±2.29 (-2.70, 6.00), the area under the curve was 0.909, the best diagnostic cut-off value was 1.05, the sensitivity was 97.99%, and the specificity was 81.90%. The average Z value of ovarian volume with CPP children was 7.49±7.49 (-0.48, 36.99), the area under the curve was 0.939, the best diagnostic cut-off value was 2.15, the sensitivity was 100.00%, and the specificity was 80.90% and the average Z value of ovarian volume with was 4.59±4.19 (-1.15, 22.79), the area under the curve was 0.839, the best diagnostic cut-off value was 1.13, the sensitivity was 90.80%, and the specificity was 85.10%. Conclusion Uterine and ovarian ultrasound combined with Z-score method can effectively diagnose PPP and CPP, which play a crucial role in the diagnosis of precocious puberty in children and adolescent females, worthy of clinical promotion.

Key words： Uterus Ovary Ultrasound Z-score method Female Precocious puberty

基金资助:广东省中医药局科研项目（20172020）。

通讯作者: ▲通讯作者

引用本文:

仲先玲1 张国强2▲ 蒋双兰1 易全英1 卜秋强1 余凤1. 子宫卵巢超声结合Z-score方法对女性性早熟的诊断价值[J]. 中国医药导报, 2020, 17(23): 70-73,94.
ZHONG Xianling1 ZHANG Guoqiang2▲ JIANG Shuanglan1 YI Quanying1 BU Qiuqiang1 YU Feng1. Diagnostic value of uterine and ovarian ultrasound combined with Z-score method in female precocious puberty. 中国医药导报, 2020, 17(23): 70-73,94.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I23/70

[1] Lee PA. Central precious puberty. An overview of diagnosis，treatment，and outcome [J]. Endocrinol Metab Clin North Am，1999，28（4）：901.
[2] Schoelwer MJ，Donahue KL，Didrick P. One-year follow-up of girls with precocious puberty and their mothers：do psychological assessments change over time or with treatment [J]. Horm Res Paediatr，2017，88（5）：347-353.
[3] Chirico V，Lacquaniti A，Salpietro VJ. Central precocious puberty：from physiopathlogical mechanism to treatment [J]. Biol Regul Homeost Agents，2014，28（3）：367-375.
[4] Ghizzoni L，Gasco V. Premature pubarche [J]. Horm Res Paediatr，2010，73（5）：420-422.
[5] ?覶atlι G，Erdem P，Anιk A，et al. Clinical and laboratory findings in the differential diagnosis of central precocious puberty and premature thelarche [J]. Turk Pediatri Ars，2015， 50（1）：20-26.
[6] Calcaterra V，Sampaolo P，Klersy C，et al. Utility of breast ultrasonography in the diagnostic work-up of precocious puberty and proposal of a prognostic index for identifying girls with rapidly progressive central precocious puberty [J]. Ultrasound Obstet Gynecol，2009，33（1）：85-91.
[7] 吴淑珠，朱艺玲，杨小玲.超声在女童性早熟鉴别诊断中的价值[J].泰山医学院学报，2016，37（5）：559-560.
[8] 熊伟律，胡新娥，陈文显，等.超声检查在鉴别女童真假性性早熟中的应用[J].中国妇幼健康研究，2016，24（6）：758-760.
[9] 中华人民共和国卫生部.性早熟诊疗指南（试行）[J].中国儿童保健杂志，2011，19（4）：391-392.
[10] 杨利芬，钟挺.彩色多普勒超声在诊断女童性早熟及观察治疗效果中的价值[J].中国妇幼保健，2016，31（11）：2393-2394.
[11] Badouraki M，Christoforidis A，Economou I，et al. Evaluation of pelvic ultrasonography in the diagnosis and differentiation of various forms of sexual precocity in girls [J]. Ultrasound Obstet Gynecol，2008，32（6）：819-827.
[12] de Vries L，Phillip M. Role of pelvic ultrasound in girls with precocious puberty [J]. Horm Res Paediatr，2011，75（2）：148-152.
[13] 王蕾.特发性中枢性性早熟女童GnRHa治疗前后心理行为的变化[J].中外医学研究，2018，16（15）：99-100.
[14] 李晓冬，阎雪，陈丽华.腔内超声对儿童青春期性发育状态的评价[J].中华医学杂志，2012，92（17）：1187-1189.
[15] 刘桂香，徐丽娥，李杰基，等.超声检查中枢性性早熟女童的临床分析[J].现代医用影像学，2019，26（9）：2093-2094.
[16] 庞厚清，欧阳力雪，宋清芸，等.儿童至青春期子宫卵巢超声测值及超声对性早熟的诊断价值[J].四川大学学报：医学版，2019，48（4）：583-587.
[17] 胡诗音，陈晓康，陈泽坤，等.三维超声VOCAL技术在女童性早熟中的早期诊断及临床应用价值[J].岭南急诊医学杂志，2018，19（6）：580-583.
[18] 赵铃铃，徐海燕，高勇.超声检查对女童中枢性性早熟的诊断价值[J].交通医学，2018，32（4）：400-401.
[19] 刘津梅，周贵明，牛悦，等.超声在女童性早熟病因分析中的研究进展[J].影像研究与医学应用，2018，2（16）：3-5.
[20] 阮伟伟.彩色多普勒超声对女童特发性性早熟的临床诊断价值[J].中国现代医生，2017，11（16）：94-96，169.
[21] 马沉沉，周贵明.彩色多普勒超声结合性激素检查在诊断女童性早熟中的价值[J].继续医学教育，2017，31（2）：142-143.