阮伟伟

[摘要] 目的 探讨分析彩色多普勒超声对女童特发性性早熟的临床诊断价值。 方法 选择我院收治确诊的68例特发性性早熟女童作为性早熟组，在将其分为中枢性性早熟组（CPP组）21例、外周性性早熟组（PPP组）47例，再选择50例健康女童作为对照组，对各组儿童进行彩色多普勒超声检查，并对检查结果进行比较分析。 结果 性早熟组女童彩色多普勒超声检查子宫容积、卵巢容积、卵泡个数、最大卵泡直径及子宫内膜厚度均显著高于对照组，差异有统计学意义（P<0.05）；CPP组儿童其子宫容积、卵巢容积、卵泡个数以及最大卵泡直径均显著高于PPP组，差异有统计学意义（P<0.05）。 结论 彩色多普勒超声检查对女童特发性性早熟的鉴别诊断具有重要临床价值，且检查方便、无创，患儿痛苦少，容易被患儿及其家长所接受，值得临床推广。

[关键词] 彩色多普勒超声；特发性性早熟；女童；诊断

[中图分类号] R729 [文献标识码] B [文章编号] 1673-9701（2017）16-0094-03

[Abstract] Objective To explore the clinical diagnostic value of color Doppler ultrasonography in girls with idiopathic precocious puberty. Methods 68 girl patients with idiopathic precocious puberty admitted in our hospital were selected as the precocious puberty group. Then the girl patients were divided into central precocious puberty group（CPP group） with 21 cases and peripheral precocious puberty group （PPP group） with 47 cases. 50 healthy girls were selected as the control group. Color Doppler ultrasonography was performed on each group of children， and the results were compared and analyzed. Results The uterine volume， ovarian volume， follicle number， maximal follicular diameter and endometrial thickness detected by color Doppler ultrasonography were significantly higher in the precocious puberty group than those in the control group， and the differences were significant（P<0.05）. The uterine volume， ovarian volume， follicle number， maximal follicular diameter in the CPP group were significantly higher than those of PPP group， and the differences were significant（P<0.05）. Conclusion Color Doppler ultrasonography has important clinical value in the differential diagnosis of idiopathic precocious puberty girls， and it is convenient and noninvasive to check， which causes less pain in children and is easy to be accepted by children and their parents，and it is worthy to be popularized.

[Key words] Color Doppler ultrasound； Idiopathic precocious puberty； Girls； Diagnosis

机体生殖系统的发育与功能维持受下丘脑-垂体-性腺轴的控制，而生殖系统的发育和功能发动迟早受到机体营养代谢、种族差异及心理状态等因素的影响[1]。性早熟指的是女童在8岁以前、男童在9岁以上出现的第二性征，按照儿童性早熟的发病机制以及性早熟儿童的临床表现，可将其分为两种，分别为中枢性与外周性，其中中枢性早熟又被称为真性性早熟，主要为一种促性腺激素释放激素依赖性早熟；此外，外周性性早熟又被成为假性性早熟，这是一种非促性腺激素释放激素依赖性性早熟[2，3]。目前对于性早熟的诊断多以促性腺激素释放激素（GnRH）激发试验为“金标准”，但临床上应用該方法具有诊断费用高的缺点，且需要对患儿进行多次抽血，因此采取此种方法患儿及技术的配合程度较差，为临床诊断带来了一定的难度[4，5]。……