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目的 以LHRH兴奋试验鉴别诊断体质性青春发育延迟 (constitu tionaldelayedpuberty ,CDP)和男性低促性腺激素性性功能低减 (hypogonadotropichypogonadism ,HH)。 方法 所有患者试验时均处于生殖发育第Ⅰ期 ,试验时给患者静脉注射LHRH 10 0 μg ,分别于 -15、0、15、3 0、45、60、90及 12 0min取血 3毫升 ,用放免法测定血清黄体生成素 (LH)和促卵泡激素 (FSH )水平。此后患者在门诊每 3～ 2 4个月随诊一次 ,一直追查到 18岁以后即至确诊有无正常青春发育后为止。根据其青春发育情况将患者分为青春发育正常组 (n =3 4) ,CDP组 (n =16)及HH组 (n =3 1)。 3组患者接受LHRH兴奋试验的年龄分别为 ( 10 .2± 0 .9)岁 ( 9～ 14岁 ) ,( 16.0± 1.0 )岁 ( 14～ 18岁 )和 ( 17.1± 1.4)岁 ( 16～ 2 2岁 )。结果 正常组 ,CDP组和HH组血清LH基础值和达峰时间均无差异 ,而血清LH峰值 ,血清LH峰值与基础值间的差值即血清LH增加值 ,血清LH增加倍数及血清LH曲线下面积 (AUCLH) ,正常组均明显高于CDP组和HH组 (P均 <0 .0 0 1) ,CDP组也明显高于HH组 (P均 <0 .0 0 1)。在 3组受试者中 ,分别绘制血清LH峰值、LH增加值对LHRH兴奋试验的工作特性曲线 (ROC) ,根据ROC可以确定以下两指标的切点 :血清LH峰值 8IU/L ,血清LH增?
OBJECTIVE: To determine the relationship between constitutional delayed puberty (CDP) and hypogonadotropy hypogonadism (HH) by LHRH test. Methods All patients were in reproductive stage Ⅰ during the test. The patients were given intravenous injection of LHRH 10 0 μg at 3, 5, 10, 15, 30, 45, 60, 90 and 120 min respectively, Serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels were measured by radioimmunoassay. Since then, patients in the clinic every 3 to 24 months follow-up time, has been traced to 18 years of age or even diagnosed with normal youth until after. According to their adolescent development, the patients were divided into normal group (n = 34), CDP group (n = 16) and HH group (n = 31). The age of the patients who underwent LHRH test in the three groups were (10 .2 ± 0. 9) years old (9 to 14 years old), (16.0 ± 1.0) years old (14 to 18 years old) and (17.1 ± 1.4 years old) 22 years old). Results There was no difference in serum LH and peak time between normal group, CDP group and HH group, but the difference between serum LH peak value, serum LH peak value and baseline value was the increase of serum LH, the increase of serum LH and the serum LH curve The area under the AUCLH was significantly higher in the normal group than in the CDP group and the HH group (all P <0.01), and also significantly higher in the CDP group than in the HH group (P <0.01). In the three groups of subjects, the working curve (ROC) of the peak value of LH and the value of LH in the LHRH stimulation test were respectively plotted. According to the ROC, the following two indexes can be determined: the peak value of serum LH is 8 IU / L, ?