简易化黄体生成素释放激素激发试验诊断性早熟

Role of Simplified Luteinizing Hormone-Releasing Hormone Stimutation Test in Diagnosis of Precocious Puberty

目的通过对性早熟患儿黄体生成素释放激素(LHRH)激发试验中各时间段黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)水平分析,探求激发试验的简易化。方法运用全自动化学发光免疫分析系统(ACS:180)检测60例性早熟患儿基础血清E2、T、FSH、LH水平及LHRH激发试验后血清FSH、LH水平,并进行比较。结果中枢性性早熟(CPP)组39例LHRH注射30 min后FSH和LH明显升高(Pa<0.01),LH/FSH>1,LH峰值>12 IU/L。周围性性早熟(PPP)组21例注射LHRH前及注射后30、60、90 min后,血LH、FSH无显著变化(Pa>0.05)。E2和T水平于注射前和注射后60 min无差异显著性(P>0.05)。二组LH、FSH高峰均集中在30、60 min。结论LHRH激发试验主要依据LH峰值和LH/FSH值来判断;激发试验可简化为LHRH激发前和激发后30、60 min分别抽血检测LH、FSH,即能为临床提供诊断依据。

Objective To explore the simplified method by examining the levels of luteinizing hormone （LH）, follicle - stimulating hor- mone（ FSH）, estradid （E2 ） and stosterone （T） at different times in the stimutation test of luteinizing hormone -releasing hormone（LHRH）. Methods Sixty patients with precocious puberty accepted LHRH stimutation test. The levels of E2,T, FSH, LH before injection and after 30, 60,90 minutes were compaired. The levels of stimulalion test of LHRH examined with ACS：180 chemiluminesence. Results There were 39 patients in the group of central precocious puberty（CPP）. The levels of FSH and LH in CPP group significantly increased after LHRH 30 minutes injection. The ratio of LH/FSH was higher than 1. The peak level of LH was higher than 12 IU/L. There were 21 patients in group of peripheral precocious puberty（PPP）. Compared with the results before injection, the levels of LH were similar to the results of 30,60 and 90 minutes after LHRH injection. Compared with the result before injection, the levels of E2 and T were similar to the result of 60 minutes after LHRH injection. The peak levels of LH and FSH in two groups all focused in 30,60 minutes. Conclusions LHRH stimutation test is mainly based on the peak level of LH and the ratio of LH/FSH, the test dan he simplified to examine the levels the of LH and FSH before the test and 30,60 minutes after injection as a basis for the clinical diagnosis.