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下丘脑-垂体-性腺轴(hypothalamic-pituitary-gonadal axis,HPGA)对人体生殖系统的发育、功能状态的维持具有重要的作用,判断HPGA功能状态是儿童性发育异常性疾病诊疗路径中的关键步骤之一。目前大家公认的评估儿童HPGA功能状态的实验室金标准是经典的促性腺激素释放激素(gonadotropin releasing hormone,GnRH)激发试验,但该试验存在采血次数多、费用较高、操作复杂、患儿及家长依从性差等缺点,使其在临床应用方面受到一定限制。随着促性腺激素(gonadotrophin,Gn)检测技术的发展,检测灵敏度得到了极大提高,为临床及科研工作者寻求更简单、更方便的方法来评估HPGA功能状态创造了条件。本文主要阐述目前在简化GnRH激发试验以及探索可替代经典的GnRH激发试验来评估HPGA功能状态的研究现状。
Hypothalamus-pituitary-gonadal axis (HPGA) plays an important role in the development of human reproductive system and maintenance of functional status. Determining HPGA functional status is a key step in the diagnosis and treatment of childhood sexual dysplasia one. At present, the accepted laboratory gold standard for assessing the functional state of children’s HPGA is the classic gonadotropin releasing hormone (GnRH) challenge test, but there are many blood sampling times, high costs and complex operations in children and children Parents poor compliance and other shortcomings, so that it is subject to certain restrictions in clinical applications. With the development of gonadotrophin (Gn) detection technology, the detection sensitivity has been greatly improved, which has created the conditions for clinical and research workers to seek an easier and more convenient method to assess the functional status of HPGA. This article focuses on the present state of the art in assessing the functional status of HPGA by simplifying the GnRH provocation test and by exploring alternatives to classical GnRH provocation tests.