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卵巢及子宫形态学检查和GnRH激发试验的关系

丁玉达1,杨箐岩2,刘戈力1,郑荣秀2   

  1. 1. 天津医科大学总医院儿科
    2. 天津医科大学总医院
  • 收稿日期:2011-06-14 修回日期:2011-11-08 出版日期:2012-05-15 发布日期:2012-05-15
  • 通讯作者: 丁玉达

Study on the Relationship Between Serum E2 Levels, GnRH stimulation test and Morphologic changes of Ovary and Uterus in Girls with Precocious puberty

2, 2   

  • Received:2011-06-14 Revised:2011-11-08 Published:2012-05-15 Online:2012-05-15

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摘要： 目的：通过测定基础血清E2、FSH、LH和GnRH激发试验30分钟和60分钟LH值和FSH值以及子宫和卵巢形态改变，探讨性腺影像学诊断在特发性中枢性性早熟诊断中的价值。方法：对36例性早熟女童进行了盆腔Ｂ超检查，测量卵巢、子宫体积、卵泡最大直径，基础血清E2、FSH、LH水平的变化情况及GnRH激发试验后血清FSH、LH水平并进行比较。结果：（1）不同型卵巢的基础血清LH，E2， GnRH激发试验30分钟LH∕FSH值，及GnRH激发试验60分钟LH∕FSH值差异有显著性（p<0.05），且呈递增趋势。（2）最大卵泡直径与基础血清E2和LH值相关（p<0.05）且与GnRH激发试验后30分钟及60分钟LH∕FSH值相关（p<0.01），且与卵巢总容积相关。（3）子宫容积与血清LH，E2及GnRH激发试验30分钟及60分钟LH∕FSH值显著相关（p<0.01）；（4）卵巢容积与血清LH及GnRH激发试验30分钟及60分钟LH∕FSH值相关。结论：（1）LH与卵泡发育相关，E2的水平主要取决于卵泡发育状态。（2）子宫体容积与E2显著相关，子宫的发育呈雌激素依赖性。（3）GnRH激发试验和卵巢、子宫形态学检查综合判断有助于对中枢性性早熟做出诊断。

关键词: 性早熟, 子宫 , 卵巢, GnRH激发试验, E2

Abstract: Objective: To explore the value of ultrasound in diagnosing idiopathic central precocious puberty through study on the relationship between serum E2, FSH, LH levels and morphologic changes of uterus and ovary. Methods: Thirty-six girls with precocious puberty accepted GnRH stimulation tests and pelvic ultrasound examinations .The levels of E2, TSH, LH before injection and after 30, 60 minutes , and ovarian volume , uterine volume ,maximum follicular diameter were reviewed and analysed. Results: (1) Among the three types of ovaries (type1, homogeneous type ; type 2 , small follicular type ; type 3, large follicular type ), differences of the serum LH ,E2 levels and the ratio of LH∕FSH after GnRH 30 minutes and 60 minutes were significant (p<0.05).(2) The maximal follicular diameter was correlated to the serum LH ,E2,the ratio of LH∕FSH after GnRH 30 minutes and 60 minutes and the volume of ovary. (3) The volume of uterus was correlated to the serum LH,E2 levels and the ratio of LH∕FSH after GnRH 30 minutes and 60 minutes. (4) The volume of ovary was correlated to the serum LH levels and the ratio of LH∕FSH after GnRH 30 minutes and 60 minutes. Conclusion: (1)There was close relationship between LH levels and follicular development .It also proved that serum E2 levels was mainly decided by the development status of the follicles.(2)The volume of uterus was significantly correlated to E2 levels. Development of uterus was estrogen-dependent. (3)Judgement based on GnRH stimulation test and morphologic changes of uterus and ovary would be crucial for establishing the diagnosis of idiopathic central precocious puberty.

Key words: Precocious puberty, Uterus, Ovary, GnRH stimulation test, serum E2