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 precocious 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:(1)CPP组晨尿黄体生成素(luteinzing hormone,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 cm3、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。
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 25.0software was used for statistical analysis of the data,and receiver operating characteristic curve(ROC)was drawn. Results:(1)The 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).(2)The 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 serum,uterine volume and ovarian volume(P < 0.001).(3)The area under ROC curve(AUC),threshold,sensitivity and specificity of morning urine LH for diagnosis of CPP were 0.879,2.12 U/L,82.1%,88.0%,respectively;and AUC,threshold,sensitivity and specificity of uterine volume for diagnosis of CPP were 0.935,1.87 cm3,87.2%,88.0%,respectively;the sensitivity and specificity of serum basal LH(≥0.3 U/L)for CPP diagnosis were 89.7% and 80.0%,respectively.(4)The AUC,sensitivity and specificity of the combination of morning urine LH,uterine volume and blood-based LH for diagnosis of CPP were 0.977,92.3% and 96.0%,respectively. Conclusion:Morning urine LH combined with uterine volume and blood-based LH can be used as preliminary screening indicators for CPP in girls,which is non-invasive and convenient. These indicators can further improve the preliminary diagnostic efficacy of CPP,and have certain clinical application value.
作者
许媛媛
王婕
汤勇泉
朱艳丽
汤爱梅
谷奇
谭娟
李月娥
周文娣
XU Yuanyuan;WANG Jie;TANG Yongquan;ZHU Yanli;TANG Aimei;GU Qi;TAN Juan;LI Yue’e;ZHOU Wendi(Department of Pediatrics,the Affiliated Huai'an No.I People's Hospital of Nanjing Medical University,Huai'an 223300;Department of Pediatrics,Huaian Clinical College of Xuzhou Medical University,Huai'an 223300,China)
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2022年第11期1572-1577,共6页
Journal of Nanjing Medical University(Natural Sciences)
基金
江苏省妇幼保健协会项目(FYX202213)。
关键词
尿促性腺激素
盆腔超声
性早熟
女童
诊断
urinary gonadotropins
pelvic ultrasound
precocious puberty
girls
diagnosis
