摘要
目的:探讨性早熟(PP)女性患儿的生殖系统超声参数与内分泌激素表达的关系以及对治疗效果的评估.方法:选取2021年1-12月在北京京煤集团总医院就诊的160例疑似PP女性患儿,依据PP诊断将其分为阳性组和正常组,每组80例.对两组患儿进行子宫、卵巢及乳腺的超声检查,测量相关参数,并检测血清中的内分泌激素水平.对阳性组患儿进行治疗后,再次行超声检查和内分泌激素检测,评估治疗效果.比较两组间的超声参数与内分泌激素差异及相关性,以及对治疗效果的影响因素.结果:阳性组患儿的子宫长径、厚径、宫体与宫颈长度之比,以及宫内膜厚度、卵巢大小、卵泡数量、乳腺低回声区宽径和厚度均显著大于正常组,差异有统计学意义(t=16.8、12.6、12.4、14.7、11.5、15.8、10.9、10.2,P＜0.05);阳性组子宫动脉阻力指数(RI)为0.58±0.07,显著小于正常组(0.67±0.06),差异有统计学意义(t=-7.9,P＜0.05).阳性组患儿的血清雌二醇(E2)、促性腺激素(GnRH)、促卵泡激素(FSH)、黄体生成素(LH)、孕酮(P)及生长激素(GH)水平均显著高于正常组,差异有统计学意义(t=20.6、19.8、15.4、17.6、15.2、8.9,P＜0.05).阳性组患儿经过治疗后,上述超声参数和内分泌激素水平均有明显改善.相关分析显示,超声参数与内分泌激素水平呈正相关,是内分泌激素水平的重要影响因素,治疗效果与超声参数(OR=0.78～1.28,P＜0.05)、内分泌激素水平(OR=0.73～0.77,P＜0.05)、年龄、身高、体重、体质量指数(BMI)等因素有关(OR=0.70～0.72,P＜0.05).结论:PP女性患儿的生殖系统超声参数与内分泌激素表达有密切的关系,内分泌激素水平可以作为PP女性患儿的病情和预后的重要指标.
Abstract
Objective:To explore the relationship between the ultrasound parameters of reproductive system and the expression of endocrine hormone in female pediatric patients with precocious puberty(PP),and to assess the treatment effect.Methods:A total of 160 female pediatric patients with PP who admitted to Beijing Jingmei Group General Hospital from January 2021 to December 2021 were selected,and they were divided into a positive group and a normal group based on the diagnostic criteria for precocious puberty,with 80 cases in each group.Ultrasound examination was performed on the uterus,ovaries and breasts of 160 female pediatric patients with PP,and the relevant parameters of them were measured,and the levels of endocrine hormone in the serums of them were detected.The pediatric patients of positive group underwent again the ultrasound examination and the detection of endocrine hormone after they completed treatment.The differences of ultrasound parameters and endocrine hormone between two groups were compared,and the correlation of ultrasound parameters and endocrine hormone between two groups were analyzed,as well as the influence factors of treatment effect.Results:The length and thickness of the uterus,the ratio of the length of the uterus to the length of cervix,the thickness of the endometrium,the size of the ovaries,the number of follicles,and the width and thickness of the hypoechoic area of the breast in the positive group were significantly larger than them in the normal group,and the differences of them were statistical significance(t=16.8,12.6,12.4,14.7,11.5,15.8,10.9,10.2,P<0.05),respectively.The resistance index(RI)of uterine artery of positive group was significantly smaller than that of normal group,and the difference was statistically significant(t=-7.9,P<0.05).The serum estradiol(E2),gonadotropin(GnRH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),progesterone(P)and growth hormone(GH)levels of positive group were significantly higher than those of normal group,and the differences of them were significant(t=20.6,19.8,15.4,17.6,15.2,8.9,P<0.05),respectively.After treatment,the above-mentioned ultrasound parameters and endocrine hormone levels of the pediatric patients in the positive group were significantly improved.The relevant analysis showed that ultrasound parameters were positively correlated with levels of endocrine hormone,and they were important influence factor on the levels of endocrine hormone.In addition,the treatment effect was related to ultrasound parameters(OR=0.78-1.28,P<0.05),the levels of endocrine hormone(OR=0.73-0.77,P<0.05),age,height,weight and BMI(OR=0.70-0.72,P<0.05).Conclusion:The ultrasound parameters of the reproductive system of female pediatric patients with PP are closely related to the expression of endocrine hormones.The levels of endocrine hormones can be used as important indicators of the disease condition and prognosis of female pediatric patients with PP.
基金项目
北京市卫生健康委科研专项(首发2020-4-1077)
国家科技期刊平台
NSTL
万方数据