论文部分内容阅读
目的探讨免疫化学发光法(ICMA)检测夜间12 h尿促性腺激素对判断儿童促性腺激素释放激素类似物(GnRHa)治疗后下丘脑-垂体-性腺轴(HPGA)功能状态的价值。方法患儿12例,其中中枢性性早熟4例(女,年龄7.3～9.8岁),青春期预测终身高矮小8例(男3例,女5例;年龄8.8～12.3岁)。在GnRHa治疗前及治疗3个月后检测其夜间12 h尿黄体生成素(LH)和卵泡刺激素(FSH)。结果 GnRHa治疗前后患儿夜间12 h尿液LH/Cr分别为(339.14±264.02)IU.mol-1和(43.39±36.65)IU.mol-1(t=3.727,P=0.003),FSH/Cr分别为(1 841.59±1 287.46)IU.mol-1和(348.20±165.22)IU.mol-1(t=3.968,P=0.002),当尿LH/Cr>56.44 IU.mol-1同时又有FSH/Cr>604.97 IU.mol-1时,其灵敏度及特异性分别为91.7%及100.0%;而仅当FSH/Cr>604.97 IU.mol-1时,诊断HPGA未被抑制状态具有93.8%的灵敏度及85.7%的特异性;仅当LH/Cr>56.44 IU.mol-1时,则其具有91.7%的灵敏度及83.3%的特异性。结论夜间12 h尿液LH/Cr和FSH/Cr可用来判断GnRHa治疗后HPGA功能状态。
Objective To investigate the value of immunochemiluminescence (ICMA) assay for determining the function of hypothalamus-pituitary-gonadal axis (HPGA) after 12-h urinary gonadotropin (npH) assay at night in children with gonadotropin-releasing hormone analogue (GnRHa) treatment. Methods There were 12 cases of children with central precocious puberty in 4 cases (female, aged 7.3-9.8 years), and the predicted adolescent height in 8 cases (3 males and 5 females; age 8.8-12.3 years). The nocturnal LH and FSH were measured 12 hours after GnRHa treatment and 3 months after treatment. Results The LH / Cr of urine of children with GnRHa before and after treatment for 12 hours were (339.14 ± 264.02) IU.mol-1 and (43.39 ± 36.65) IU.mol-1 (1 841.59 ± 1 287.46) IU.mol-1 and (348.20 ± 165.22) IU.mol-1 respectively (t = 3.968, P = 0.002). When urinary LH / Cr> 56.44 IU.mol- Sensitivity and specificity were 91.7% and 100.0% for the FSH / Cr> 604.97 IU.mol-1, respectively, and 93.8% for the uninhibited HPGA when FSH / Cr> 604.97 IU.mol- Sensitivity and 85.7% specificity; 91.7% sensitivity and 83.3% specificity only when LH / Cr> 56.44 IU.mol-1. Conclusions The urine LH / Cr and FSH / Cr at 12 h at night can be used to judge the functional status of HPGA after GnRHa treatment.