简化曲普瑞林激发试验与女童下丘脑—垂体—性腺轴启动

发布时间：2018-10-13 09:17

【摘要】：目的评估简化曲普瑞林(达必佳，促性腺激素释放激素类似物)激发试验在女童下丘脑-垂体-性腺轴(HPGA)启动中的临床意义。 方法在108例(性早熟87例、矮小症13例和青春期预测终身高矮小8例)女童中，HPGA启动者79例，未启动者29例。所有患儿均行曲普瑞林激发试验(08:30a.m.，0.1mg/次，皮下注射)，于0、20、40和60min采血样各2mL者为90例；在另18例中，16例采血时间为0、30和60min，，1例为0和40min，1例为0和60min。应用免疫化学发光分析法(ICMA)检测促黄体生成素(LH)和卵泡刺激素(FSH)。 结果在90/108例女童中，启动者与未启动者的LH峰值(PLH)分别为(20.24±15.39)和(2.56±1.03) IU/L， PLH/FSH峰值(PFSH)分别为(1.35±0.94)和(0.32±0.42)，P均≤0.01；曲普瑞林激发试验40min LH(91/108例)、60min LH(107/108例)、PLH(90/108例)诊断HPGA启动的受试者工作特性曲线下面积分别为0.990、0.982和0.990；当Youden指数最大时，即40min LH、60min LH、PLH分别≥4.09、4.04和4.22IU/L时，其诊断HPGA启动的灵敏度分别为93.9%、96.2%和96.9%，对应的特异度均为100.0%；当40和60min的LH≥4.22IU/L时，其诊断HPGA启动的灵敏度分别为90.9%和96.2%，对应的特异度均为100.0%。当PLH/PFSH≥0.47时，其诊断HPGA启动的灵敏度和特异度分别为83.1%和96.0%。 结论1h的曲普瑞林激发试验(ICMA检测法)为评估女童HPGA启动的可靠实验室指标，其40或60min单次血促性腺激素诊断价值与促性腺激素峰值接近。
[Abstract]:Objective to evaluate the clinical significance of simplified triplatin stimulation test in the initiation of hypothalamus-pituitary-gonadal axis (HPGA) in girls. Methods among 108 girls (87 cases of precocious puberty, 13 cases of dwarfism and 8 cases of predicted lifetime high dwarf in puberty), 79 cases were HPGA promoter and 29 cases were not. All the children were given triplatin stimulation test (0 8: 30 a.m.-1 mg / time, subcutaneously injection). 90 cases were collected blood samples from 0 ~ 20 min and 60min (90 cases), and 16 cases (0 30 min and 60 min) were collected blood in 0 30 and 60 min, 1 case 0 and 40 min, 1 case 0 and 60 min. Detection of luteinizing hormone (LH) and follicle stimulating hormone (FSH). By immunochemiluminescence (ICMA) Results in 90 / 108 girls, the peak (PLH) of LH was (20.24 卤15.39) and (2.56 卤1.03) (PFSH) in promoter and non-promoter, respectively (1.35 卤0.94) and (0.32 卤0.42), P 鈮

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