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为了探讨促黄体生成素释放激素(LHRH)激发试验中LH峰值对中枢性性早熟(CPP)女童促性腺激素释放激素类似物(Gn RHa)疗效的评估价值。选取2014年1月~2016年1月我院收治的中枢性性早熟(CPP)女童40例,给予Gn RHa(曲普瑞林)50~100μg/kg肌肉注射,1次/28 d。治疗3个月及以后的每6个月进行LHRH激发试验,分别取LH峰值<1 IU/L、<2 IU/L、<3 IU/L作为LH受抑的界限值,与临床发育受抑情况进行比对,计算3个LH峰值诊断发育受抑的灵敏度、特异度及准确度。40例患儿治疗疗程为6~24个月,共完成了119次LHRH激发试验。治疗后6个月的基础LH值较治疗前明显降低((0.46±0.17)IU/L vs(0.81±0.26)IU/L),差异具有统计学意义(t=1.273,p<0.05);Pearson相关性分析:基础LH值与LH峰值之间呈线性正相关(r=0.712,p<0.05)。LH峰值<2 IU/L诊断临床发育受抑的灵敏度、特异度和准确度分别为88.9%、100.0%、99.2%。LHRH激发试验中LH峰值<2 IU/L可以作为判断CPP女童Gn RHa治疗效果的有效指标。
To investigate the value of LH peak in the LHRH test to evaluate the efficacy of gonadotropin-releasing hormone analogue (Gn RHa) in girls with central precocious puberty (CPP). Forty patients with central precocious puberty (CPP) admitted from January 2014 to January 2016 in our hospital were intramuscularly injected with Gn RHa (triptorelin) 50-100 μg / kg once daily for 28 days. LHRH stimulation test was conducted every 6 months after 3 months of treatment. LH peak values <1 IU / L, <2 IU / L and <3 IU / L were taken as limit of LH suppression, The conditions were compared and the sensitivity, specificity, and accuracy of the three LH peak diagnosis and developmental depressions were calculated. 40 cases of children treated for 6 to 24 months, a total of 119 completed LHRH provocation test. The basal LH value at 6 months after treatment was significantly lower than that before treatment (0.46 ± 0.17 IU / L vs 0.81 ± 0.26 IU / L), with significant difference (t = 1.273, p <0.05); Pearson Correlation analysis: There was a linear positive correlation between basal LH value and LH peak (r = 0.712, p <0.05). The sensitivity, specificity and accuracy of LH peak value <2 IU / L in the diagnosis of clinical development were 88.9%, 100.0% and 99.2%, respectively. LHRH excitation test LH peak <2 IU / L can be used as a judge CPP girl Gn RHa treatment of effective indicators.