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目的探讨定量测定尿促性腺激素(UGn),包括尿黄体生成素(ULH)、尿卵泡刺激素(UFSH)在女童性发育中的应用价值。方法以2013年10月至2015年2月在上海交通大学附属瑞金医院儿内科因乳房发育就诊的109例女童作为研究对象。109例均诊断为性早熟或青春发育提前。收集其就诊第1、2日晨尿,检测UGn浓度。就诊第2日晨采血,行促性腺激素释放激素(GnRH)激发试验,并收集试验后4 h内总尿,测UGn。结果 (1)连续2日晨尿UGn浓度差异无统计学意义,与血Gn基础值显著相关。(2)Gn RH激发试验后4 h总尿UGn浓度与血Gn峰值呈显著相关,激发试验后血和尿的LH/FSH比值也呈显著相关。(3)尿、血Gn水平评估TannerⅡ期与TannerⅢ期的价值相似。(4)晨尿ULH、激发后4h总ULH及ULH/UFSH比值有助于临床鉴别乳房早发育(PT)和中枢性性早熟(CPP)。结论检测UGn对于判断女性儿童性发育程度有一定意义,可作为一种无创而灵敏的诊断方法。
Objective To investigate the value of quantitative determination of uric acid (UGn), including urinary luteinizing hormone (ULH) and urofollicer stimulating hormone (UFSH) in female sexual development. Methods From October 2013 to February 2015, 109 girls with breast development attending the Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University were studied. 109 cases were diagnosed as precocious puberty or early adolescent development. Morning urinalysis was collected on the first and second days of treatment, and the concentration of UGn was detected. On the morning of the second day of treatment, blood was collected and gonadotropin-releasing hormone (GnRH) challenge test was performed. Total urine was collected within 4 hours after the test, and UGN was measured. Results (1) There was no significant difference in morning urine UGn concentration on the 2nd consecutive day, which was significantly correlated with the baseline value of blood Gn. (2) The total urinary UGn concentration was significantly correlated with the Gn peak of blood 4 h after the Gn RH challenge test, and the LH / FSH ratio of blood and urine after the challenge test was also significantly correlated. (3) urine, blood Gn level evaluation Tanner Ⅱ period and Tanner Ⅲ phase value is similar. (4) The morning urine ULH and the ratio of total ULH and ULH / UFSH at 4h after challenge contribute to the clinical identification of early breast development (PT) and central precocious puberty (CPP). Conclusion The detection of UGn has some significance for judging the sexual development of female children, which can be used as a noninvasive and sensitive diagnostic method.