摘要
目的探讨夜尿促性腺激素与儿童下丘脑-垂体-性腺轴(HPGA)启动的关系。方法生长或发育异常患儿68例。男20例,女48例。性早熟42例(其中伴垂体微腺瘤3例),预测终身高矮小11例,生长激素缺乏症6例,特发性矮小3例,男性乳房女性化2例,颅咽管瘤(术后放疗)、超重伴垂体微腺瘤、代谢性骨病和Turner综合征各1例。均住院行促性腺激素释放激素类似物激发试验。激发试验前留取其夜间12h尿。应用免疫化学发光法检测其血清和尿促黄体生成素(LH)和卵泡刺激素(FSH),且夜尿LH(NULH)和夜尿FSH(NUFSH)用肌酐(Cr)校正。激发试验0min血液作为血自发性LH(SLH)和血自发性FSH(SFSH)标本。结果NULH/Cr与血LH峰值的相关系数为0.584,P<0.001;NUFSH/Cr与血FSH峰值的相关系数为0.206,P=0.092。NULH/Cr、NUFSH/Cr、NULH/NUFSH、SLH、SFSH和SLH/SFSH判断HPGA启动的受试者工作特性曲线下面积分别为0.790、0.665、0.713、0.762、0.799和0.634。当NULH/Cr≥68.8064IU.mol-1时,判断HPGA启动的灵敏度和特异度分别为71.8%和79.3%;当NULH/NUFSH≥0.1253时,判断HPGA启动的灵敏度和特异度分别为51.3%和89.7%;当NULH/Cr≥68.8064IU.mol-1,且NULH/NUFSH≥0.1253时,判断的灵敏度和特异度分别为48.7%和96.6%。结论应用免疫化学发光法检测夜间12h尿促性腺激素可能有助于儿童HPGA启动的判断,NULH/Cr和NULH/NUFSH的价值不低于SLH和SLH/SFSH,但NUFSH/Cr的价值可能不及NULH/Cr和NULH/NUFSH。
Objective To investigate the correlation between nocturnal spontaneous urinary gonadotropin and onset of hypothalamic-pituitary-gonadal axis（HPGA） in children.Methods Sixty-eight children（20 male,48 female） who were suffered from disorders of growth or pubertal development were hospitalized for gonadotropin releasing hormone analogue stimulating test.Forty-two cases were precocious puberty（3 cases with pituitary microadenoma）,11 cases were short stature of predicted adult height,6 cases were growth hormone deficiency,3 cases were idiopathic short stature,2 cases were gynaecomastia,4 cases suffered from craniopharyngioma （post-operative radiotherapy）,overweight with pituitary microadenoma,metabolic disease of bone and Turner′s syndrome,respectively.Twelve hours nocturnal spontaneous urine were collected before the test.The determinations of luteinizing hormone（LH） and follicle-stimulating hormone（FSH） in serum and urine were assayed by immunochemiluminometric assays（ICMA）.Nocturnal urinary LH（NULH） and urinary FSH（NUFSH） were adjusted by urinary creatinine（Cr）.Serum sample collected before the test（0 min） were regarded as spontaneous LH（SLH） and spontaneous FSH（SFSH）.Results The correlation coefficient between the ratio of NULH/Cr and serum peak LH（r=0.584,P0.001） was better than that of the ratio of NUFSH/Cr and serum peak FSH（r=0.206,P=0.092）.The areas under receiver operator characteristic curves of NULH/Cr,NUFSH/Cr,NULH/NUFSH,SLH,SFSH and SLH/SFSH for the diagnoses of onset of HPGA were 0.790,0.665,0.713,0.762,0.799 and 0.634,respectively.The sensitivity and specificity for the diagnosis of onset of HPGA were respectively 71.8% and 79.3% when NULH/Cr was no less than 68.806 4 IU·mol-1.The sensitivity and specificity were 51.3% and 89.7% respectively when NULH/NUFSH was no less than 0.125 3.When NULH/Cr was no less than 68.806 4 IU·mol-1,as well as NULH/NUFSH no less than 0.125 3,the sensitivity and specificity were 48.7% and 96.6%,respectively.Con
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第8期561-563,共3页
Journal of Applied Clinical Pediatrics
关键词
尿
促性腺激素
免疫化学发光法
下丘脑-垂体-性腺轴
儿童
urine
gonadotropin
immunochemiluminometric assays
hypothalamic-pituitary-gonadal axis
child
