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目的探讨超声检查在女童中枢性性早熟的辅助诊断及药物治疗的疗效评价。方法对28例中枢性性早熟患儿进行促性腺激素释放激素类似物(GnRHa)治疗,应用超声检测治疗前、治疗后3个月、治疗后6个月的子宫、卵巢大小及形态学变化,并与28例正常同龄女童的子宫、卵巢进行对比,予以促性腺激素释放激素(GnRH)激发试验采用化学发光法测定血清黄体生成素(LH)和卵泡刺激素(FSH)。结果中枢性性早熟女童治疗前的子宫容积、卵巢容积、卵泡直径、LH值、FSH值均大于正常女童,差异均有统计学意义(t分别=6.24、14.40、7.41、10.43、8.56,P均<0.05)。中枢性早熟女童治疗前、GnRHa治疗后3个月与6个月子宫、卵巢容积、卵泡直径、LH值、FSH值差异均有统计学意义(F分别=19.93、18.89、30.18、52.31、41.07,P均<0.05)。经LSD-t检验两两比较发现:与治疗前相比,治疗3个月和治疗6个月子宫容积、卵巢容积、卵泡直径、LH值、FSH值均下降,差异均有统计学意义(t分别=-8.32、-19.65、-7.89、-26.78、-9.61;-12.13、-9.31、-11.67、-30.15、-12.08,P均<0.05);治疗6个月与3个月相比,子宫容积、卵巢容积、卵泡直径减小,差异均有统计学意义(t分别=-5.32、-8.65、-6.89,P均<0.05);在GnRHa治疗6个月后子宫容积、卵巢容积与正常女童差异均有统计学意义(t分别=7.65、5.05,P均<0.05)。结论超声检查对中枢性性早熟女童的检出率高,对其治疗后的临床疗效的评价及疗效随访具有实用价值。
Objective To evaluate the diagnostic value of ultrasound in the diagnosis of central precocious puberty in girls and the curative effect of drug treatment. Methods 28 cases of central precocious puberty in children with gonadotropin-releasing hormone analogues (GnRHa) treatment, the application of ultrasound detection before and after treatment, 3 months after treatment, 6 months after treatment of uterine and ovarian size and morphological changes, The gonadotropin releasing hormone (GnRH) challenge test was used to compare the serum levels of LH and FSH with the uterus and ovary of 28 normal girls of same age. Results The uterus volume, ovarian volume, follicle diameter, LH value and FSH value of girls with central precocious puberty before treatment were all higher than those of normal girls (t = 6.24, 14.40, 7.41, 10.43, 8.56, P <0.05). Before treatment, the difference of uterus, ovarian volume, follicle diameter, LH value and FSH between 3 and 6 months after GnRHa treatment were statistically significant (F = 19.93, 18.89, 30.18, 52.31, 41.07, P <0.05). The results of LSD-t test showed that uterine volume, ovarian volume, follicle diameter, LH value and FSH value all decreased after 3 months of treatment and 6 months of treatment, the differences were statistically significant (t Respectively, P <0.05). Compared with 3 months, the uterus of the uterus (T = -5.32, -8.65, -6.89, respectively, P <0.05). After 6 months of GnRHa treatment, the volume of uterus, the volume of ovary and the diameter of follicles were significantly decreased The differences were statistically significant (t = 7.65,5.05, P <0.05). Conclusion The detection rate of ultrasound precocious puberty precocious girls is high, and its clinical curative effect evaluation and curative effect follow-up have practical value.