LHRH激发试验LH峰值对性早熟女童GnRHa疗效的诊断价值

The Value of the LH Peak in LHRH Stimulation Test in Diagnosis the Curative Effect of the GnRHain Treatment of the Precocious Puberty Girls

为了探讨促黄体生成素释放激素（LHRH）激发试验中LH峰值对中枢性性早熟（CPP）女童促性腺激素释放激素类似物（GnRHa）疗效的评估价值。选取2014年1月～2016年1月我院收治的中枢性性早熟（CPP）女童40例，给予GnRHa（曲普瑞林150—100μg／kg肌肉注射，1次／28d。治疗3个月及以后的每6个月进行LHRH激发试验，分别取LH峰值〈1 IU／L、〈2 IU/L、〈3 IU／L作为LH受抑的界限值，与临床发育受抑情况进行比对，计算3个LH峰值诊断发育受抑的灵敏度、特异度及准确度。40例患儿治疗疗程为6～24个月，共完成了119次LHRH激发试验。治疗后6个月的基础LH值较治疗前明显降低（（0．46±0．17）IU／L vs （0．81±0．26）IU／L），差异具有统计学意义（t=1．273，p〈0．05）；Pearson相关性分析：基础LH值与LH峰值之间呈线性正相关（r=0．712，p〈0．05）。LH峰值〈2 IU／L诊断临床发育受抑的灵敏度、特异度和准确度分别为88．9％、100．0％、99．2％。LHRH激发试验中LH峰值〈2 IU／L可以作为判断CPP女童GnRHa治疗效果的有效指标。

To explore the valuation value of the LH peak in luteinizing hormone releasing hormone （LHRH） stimulation tests in diagnosis the curative effect of the gonadotropin-releasing hormone analogue （GnRHa） in the treatment of central precocious puberty （CPP） girls. 40 cases of CPP girls from January 2014 to January 2016 were selected to give intramuscular injection of GnRHa （Triptorelin） 50-100 μg/kg, 1 time/28 d. LHRH stimulation tests were carried out after 3 months and later the every six months, respectively take LH peak 〈1 IU/L, 〈2 IU/L, 〈3 IU/L as the threshold of the inhibition of LH, and compared with the clinical growth inhibition situation, to calculate the sensitivity, specificity and accuracy of diagnosis of the growth inhibition of three LH peak. Period of treatment of 40 cases of girls were 6 to 24 months, and completed a total of 119 LHRH stimulation tests. After treated for 6 months, the basic LH value was significantly lower than before the treatment （（0.46±0.17） IU/L vs （0.81 ±0.26） IU/L）, and had statistically significant difference （t= 1.173, p 〈0.05）; The result of the Pearson correlation analysis showed that the basic values of LH and LH peak had a linear positive correlation （r=0.712, p 〈0.05）. When the LH peak〈2 IU/L, the sensitivity, specificity and accuracy of the diagnosis of the growth inhibition was 88.9%, 100.0% and 99.2% repectively. LH peak value 〈2 IU/L in LHRH stimulation test can be used as a therapeutic effective judgment index of GnRHa in treatment of the CPP girls.