论文部分内容阅读
目的探讨曲普瑞林(促性腺激素释放激素类似物)激发试验在女童曲普瑞林疗效评估中的价值。方法女童31例。其中中枢性性早熟26/31例,采用曲普瑞林(商品名达菲林)治疗;青春期预测终身高矮小4/31例和青春期特发性矮小1/31例,均予以曲普瑞林联合生长激素治疗。曲普瑞林治疗前及治疗3个月(注射下一次曲普瑞林前)均行曲普瑞林激发试验(达必佳,晨起830,每次0.1 mg,皮下注射),注射曲普瑞林0 min血样作为日间自发性促性腺激素(Gn)标本,另采集注射前夜0000血样作为夜间自发Gn标本。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)水平。结果 30/31例女童曲普瑞林治疗有效,治疗后LH峰值(PLH)最大值为1.68 IU·L-1;1/31例疗效不佳,治疗后PLH为3.81 IU·L-1。在30例治疗有效患儿中,曲普瑞林治疗后PLH[(0.98±0.39)IU·L-1]明显低于其治疗前[(26.11±16.59)IU·L-1](P=0.000),治疗后FSH峰值(PFSH)[(1.65±0.85)IU·L-1]也明显低于其治疗前[(17.78±7.09)IU·L-1](P=0.000),治疗前后PLH和PFSH均无重叠性;治疗后日间自发性LH[(0.47±0.25)IU·L-1]低于其治疗前[(1.88±3.24)IU·L-1](P=0.000),日间自发性FSH[(1.12±0.56)IU·L-1]也低于其治疗前[(5.28±4.49)IU·L-1](P=0.000)。22/30例治疗后夜间自发性LH[(0.48±0.27)IU·L-1]低于其治疗前[(4.55±4.54)IU·L-1](P=0.000),夜间自发性FSH[(1.16±0.47)IU·L-1]也低于其治疗前[(5.34±2.63)IU·L-1](P=0.000)。结论单次自发性Gn检测对生长或发育异常女童曲普瑞林疗效具有初步评估价值,曲普瑞林激发试验(ICMA检测法)可作为女童曲普瑞林疗效评估的可靠检测方法。
Objective To investigate the value of triptorelin (gonadotropin-releasing hormone analogue) provocation test in evaluating the efficacy of triptorelin in girls. Methods 31 girls. Central precocious puberty in 26/31 cases, the use of triptorelin (trade name Tamiflun) treatment; puberty predicted lifelike 4/31 cases of adolescent idiopathic short stature and 1/31 cases were triptorelin combined Growth hormone treatment. Triptorelin challenge test was performed before triptorelin treatment and 3 months of treatment (before the next triptorelin injection) (up to 8: 30, 0.1 mg, subcutaneously) Triptorelin 0 min blood samples were taken as daytime spontaneous gonadotrophin (Gn) samples, and the other night 00 00 blood samples were taken as nighttime spontaneous Gn samples. The levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured by immunochemistry chemiluminescence (ICMA). Results Thirty (31) girls were treated with triptorelin effectively, and the maximum value of LH (PLH) after treatment was 1.68 IU · L-1. The effect of one third was poor, and the PLH after treatment was 3.81 IU · L-1. The PLH (0.98 ± 0.39) IU · L-1 in triamcinolone-treated children was significantly lower than that before treatment ([26.11 ± 16.59] IU · L-1] ), And the peak FSH (PFSH) [(1.65 ± 0.85) IU · L-1] after treatment were also significantly lower than those before treatment [(17.78 ± 7.09) IU · L-1] PFSH had no overlap. After treatment, the daytime of spontaneous LH [(0.47 ± 0.25) IU · L-1] was lower than that before treatment [(1.88 ± 3.24) IU · L-1] Spontaneous FSH [(1.12 ± 0.56) IU · L-1] was also lower than that before treatment [(5.28 ± 4.49) IU · L-1] (P = 0.000). The spontaneous nocturnal LH [(0.48 ± 0.27) IU · L-1] in 22/30 patients was lower than that before treatment [(4.55 ± 4.54) IU · L-1] (1.16 ± 0.47) IU · L-1] were also lower than those before treatment [(5.34 ± 2.63) IU · L-1] (P = 0.000). Conclusions A single spontaneous Gn test has preliminary value in evaluating the effect of triptorelin in girls with abnormal growth or development. The triptorelin provocation test (ICMA test) can be used as a reliable test to evaluate the efficacy of triptorelin in girls.