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目的 :探讨乳腺超声检查在女性性早熟诊断中的应用价值。方法 :选取乳房发育的女童200例,其中单纯性乳房早发育组54例,中枢性性早熟组112例,对照组为34例青春发育早期儿童,分别进行乳腺超声检查和雌激素(E2)、孕激素、催乳素、黄体生成素(LH)峰值、促卵泡激素(FSH)峰值、骨龄等指标的检测,分析乳房超声检查结果与激素之间的相关性。结果:方差分析结果显示,中枢性性早熟组乳房体积较单纯性乳房早发育组及青春发育早期组明显增大(P<0.001),卡方检验Tanner2~4期构成比各组间差异无统计学意义。相关性分析显示乳房体积与雌激素、LH峰值、LH峰值/FSH峰值、体重指数(BMI)、骨龄呈正相关,与孕酮、催乳素、年龄、FSH峰值之间没有相关性。以乳房体积为因变量,雌激素、LH峰值、LH峰值/FSH峰值、BMI为自变量,应用多元线性回归分析乳房体积的影响因素,LH峰值/FSH峰值是影响乳房体积的相关因素(乳房体积=2.523+2.268×LH峰值/FSH峰值;P<0.001)。结论 :乳腺超声检查对乳房发育情况的评估优于Tanner分期,对单纯性乳房发育及中枢性性早熟的鉴别诊断有一定帮助,且在预测快速进展型中枢性性早熟中有一定价值。
Objective: To investigate the value of breast ultrasonography in the diagnosis of precocious puberty in women. Methods: A total of 200 girls with breast development were enrolled in this study. Among them, 54 were simple early breast development, 112 were central precocious puberty and 34 were early adolescent children in the control group. Ultrasonography and estrogen (E2) Progesterone, prolactin, luteinizing hormone (LH) peak, follicle stimulating hormone (FSH) peak, bone age and other indicators of detection, analysis of breast ultrasound findings and the correlation between hormones. Results: ANOVA showed that breast volume in central precocious puberty group was significantly higher than that in simple breast puberty group and early pubertal group (P <0.001), and there was no statistical difference in Tanner2 ~ 4 chi square test between the two groups Significance of learning. Correlation analysis showed that breast volume was positively correlated with estrogen, LH, LH / FSH, BMI and bone age, but not with progesterone, prolactin, age and FSH. According to breast volume as dependent variable, estrogen, LH peak, LH peak / FSH peak and BMI as independent variable, multiple linear regression was used to analyze the influential factors of breast volume. LH peak / FSH peak was the related factor of breast volume = 2.523 + 2.268 × LH peak / FSH peak; P <0.001). Conclusion: Breast ultrasonography is superior to Tanner staging in assessing breast development, which is helpful for the differential diagnosis of simple breast development and central precocious puberty, and it is of value in predicting rapid precocious central precocious puberty.