Department of Pediatrics, Affiliated Hospital of Hebei University, Baoding, China.
Department of Pediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
J Int Med Res. 2020 Aug;48(8):300060520935278. doi: 10.1177/0300060520935278.
To establish a diagnostic model of idiopathic central precocious puberty on the basis of transrectal pelvic ultrasound and basal gonadotropin.
A total of 669 girls with Tanner breast development stage II were enrolled in this study from January 2015 to December 2018. The participants were divided into the ICPP group and the premature thelarche group. We analyzed various variables, including age at initial diagnosis, basal luteinizing hormone levels, the long diameter of the uterus, the transverse diameter of the uterus, the anterior-posterior diameter of the uterus, the volume of the uterus, maximum ovarian diameter, average ovarian volume, maximum ovarian volume, number of follicles (≥4 mm), maximum follicular diameter, endometrial thickness, and vaginal wall thickness.
The following diagnostic model was established: Y=-14.123 + 0.630 × age at initial diagnosis + 1.119 × transverse diameter of the uterus + 1.278 × anterior-posterior diameter of the uterus + 0.637 × average ovarian volume + 1.316 × maximum ovarian diameter + 0.146 ×number of follicles ≥4 mm + 2.925 × endometrial thickness + 0.559 × basal luteinizing hormone value. The area under curve was 0.922, sensitivity was 84.9%, and specificity was 86.2%.
Basal LH levels and transrectal pelvic ultrasound should be applied together to improve the accuracy of diagnosis in ICPP.
基于直肠超声和基础促性腺激素建立特发性中枢性性早熟的诊断模型。
本研究纳入了 2015 年 1 月至 2018 年 12 月间 669 例乳房发育Ⅱ期的女童。根据诊断将患者分为特发性中枢性性早熟组（ICPP）和单纯性早初潮组，分析初诊年龄、基础黄体生成素水平、子宫长径、子宫横径、子宫前后径、子宫体积、卵巢最大直径、卵巢平均体积、最大卵巢体积、窦卵泡数（≥4mm）、最大卵泡直径、子宫内膜厚度和阴道壁厚度等各项变量。
建立了以下诊断模型：Y=-14.123+0.630×初诊年龄+1.119×子宫横径+1.278×子宫前后径+0.637×卵巢平均体积+1.316×卵巢最大直径+0.146×窦卵泡数（≥4mm）+2.925×子宫内膜厚度+0.559×基础黄体生成素值。曲线下面积为 0.922，敏感度为 84.9%，特异度为 86.2%。
基础 LH 水平和直肠超声联合应用可提高 ICPP 的诊断准确性。
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