Pokorny S F, Murphy J G, Preminger M K
Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, New Jersey, USA.
J Reprod Med. 1998 Nov;43(11):943-8.
To study the relationship between anatomic changes in the peripubertal female and sex hormonal maturation.
Medical records were reviewed on virginal females whose first gynecologic examination occurred between ages 9 and 20 and who were examined at least twice by the same gynecologist. Speculum sizes at each visit were surrogate measures of circumferential hymenal elasticity, the anatomic change of interest.
Mean ages at the two visits for the 35 patients were 14.6 and 16.7 years, respectively, with substantial overlap in ages between visits. Average Tanner breast and pubic hair stages and speculum sizes were greater at the second visit (P < .001). At first visit, age, Tanner breast and pubic hair stages, and time elapsed from menarche, thelarche and pubarche correlated positively with larger speculum sizes (P < .10). Change in speculum size between visits was associated with younger age and lower Tanner pubic hair stages at first visit and with increases between visits in age, body mass index and Tanner pubic hair stages. Larger changes were associated with shorter elapsed time between the first visit and menarche, thelarche and pubarche.
Circumferential hymenal elasticity increases during adolescence. This anatomic change, the surrogate measure of which is specula diameter, can be used along with Tanner staging as a measure of physiologic maturity in adolescent women.
研究青春期前女性的解剖学变化与性激素成熟之间的关系。
回顾了9至20岁首次接受妇科检查且由同一位妇科医生至少检查两次的未婚女性的病历。每次就诊时的窥器尺寸是感兴趣的解剖学变化——处女膜周向弹性的替代指标。
35例患者两次就诊的平均年龄分别为14.6岁和16.7岁，两次就诊年龄有大量重叠。第二次就诊时，平均坦纳乳房和阴毛分期以及窥器尺寸更大（P < .001）。第一次就诊时，年龄、坦纳乳房和阴毛分期以及月经初潮、乳房发育和阴毛发育后的时间与较大的窥器尺寸呈正相关（P < .10）。两次就诊之间窥器尺寸的变化与第一次就诊时年龄较小和坦纳阴毛分期较低以及两次就诊之间年龄、体重指数和坦纳阴毛分期的增加有关。较大的变化与第一次就诊与月经初潮、乳房发育和阴毛发育之间较短的时间间隔有关。
青春期处女膜周向弹性增加。这种解剖学变化，其替代指标为窥器直径，可与坦纳分期一起用作评估青春期女性生理成熟度的指标。
