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目的:观察黄体生成素释放激素(LHRH)激发试验在儿童性早熟诊断及治疗中的作用。方法:对28 例性早熟表现的儿章进行LHRH激发试验,测定LH及FSH值,同时测量身高、骨龄,B超测量子宫及卵巢的容积,结合身高、骨龄、子宫及卵巢容积等将性早熟患儿分真性与假性性早熟组。结果:真性性早熟组8例,假性性早熟组20例,2组LH、FSH基础值比较差异无统计学意义(P>0．05),而激发后30、60、90 min LH差异有统计学意义(P<0．05);而FSH在30 min差异有统计学意义(P<0．05),在60、90 min差异无统计学意义(P>0．05)。 4例用促性腺激素释放激素(GnRHa)类似物治疗6个月再次做LHRH激发试验,4例治疗后下丘脑-垂体-性腺轴被抑制,LH、FSH呈较低水平。4例真性性早熟患儿治疗前后LH、FSH基础值比较差异无统计学意义(P> 0．05),而激发后30、60、90 min差异有统计学意义(P<0．05)。结论:LHRH激发试验比单次测定LH、FSH更可靠,对性早熟的性质判断及治疗后疗效判断有意义。
Objective: To observe the role of LHRH in the diagnosis and treatment of precocious puberty in children. Methods: 28 cases of precocious puberty were examined by LHRH provocation test, LH and FSH were measured, height and bone age were measured simultaneously, volume of uterus and ovary was measured by B ultrasound, and precocious puberty Children with true and false precocious puberty group. Results: There were no significant differences in basal LH and FSH between the two groups (P> 0.05) in 8 cases of pseudo-precocious puberty and in 20 cases of pseudo-precocious puberty (P <0.05). However, the difference of FSH at 30 min was statistically significant (P <0.05). There was no significant difference at 60 and 90 min (P> 0.05). LHRH challenge test was performed again in 4 cases treated with GnRHa analogues for 6 months. The hypothalamic-pituitary-gonadal axis was inhibited in 4 cases and the levels of LH and FSH were lower in 4 cases. The baseline values of LH and FSH in 4 cases of precocious puberty children before and after treatment had no significant difference (P> 0.05), but the difference was statistically significant at 30, 60 and 90 minutes after challenge (P <0.05). Conclusion: The LHRH provocation test is more reliable than single measurement of LH and FSH. It is meaningful to judge the nature of precocious puberty and judge the curative effect after treatment.