曲普瑞林兴奋试验在评价男性下丘脑-垂体-性腺轴功能中的价值

目的 探讨促性腺激素释放激素类似物(曲普瑞林)兴奋试验在评价男性下丘脑-垂体-性腺轴(HPGA)功能中的价值.方法 利用曲普瑞林兴奋试验,对229例男性患者的HPGA功能进行评价,并随诊12～48个月直至确诊.通过分析不同疾病黄体生成素(LH)峰值水平和诊断之间的相关性,评价兴奋试验在疾病诊治中的价值.结果 (1)曲普瑞林兴奋试验中,LH峰值出现在注射药物后45～60 min.(2)LH峰值＜4 U/L,提示HPGA功能未启动;LH峰值在4～12 U/L,提示患者可能为体质性青春发育延迟;LH峰值＞12 U/L,提示HPGA功能已充分启动.结论 曲普瑞林兴奋试验可有效评价男性不同性腺疾病中的HPGA功能,可为体质性青春发育延迟、低促性腺激素性性腺功能减退症、假性和真性性早熟等疾病的诊治提供重要依据.

Abstract：

Objective To investigate the clinical values of luteinizing hormone-releasing hormone LHRH)α(triptorelin) stimulating test in the differential diagnoses of hypothalamus-pituitary-gonad axis (HPGA) disorders.Methods A total of 229 male patients with various HPGA disorders were recruited for triptorelin stimulating test.And all patients were followed up for 12 -48 months until a definite diagnosis was made.The values of triptorelin stimulating test in the differential diagnoses of HPGA disorders were assessed by examining the close relationship between LHmax and the final clinical diagnosis.Results (1) LH levels rose steady after an intramuscular injection of triptorelin 100 μg and the time of LHmax appeared at 45 -60min.(2) LHmax ＜4 U/L indicated the function of HPGA was not activated.LHmax in the range of 4 - 12U/L indicated the patients might have constitutional delayed puberty development.LHmax ＞ 12 U/Lindicated the fulfilled puberty development.Conclusion Triptorelin stimulating test can precisely evaluate the functions of HPGA in various HPGA disorders and provide valuable information for the differential diagnoses in constitutional delayed puberty development,hypogonadotropic hypogonadolism,central and peripheral precocious puberty disorders.

Clinical values of triptorelin stimulating test in assessing hypothalamus-pituitary-gonad axis function in male patients with hypothalamus-pituitary-gonad axis disorders

Objective To investigate the clinical values of luteinizing hormone-releasing hormone LHRH)α(triptorelin) stimulating test in the differential diagnoses of hypothalamus-pituitary-gonad axis (HPGA) disorders.Methods A total of 229 male patients with various HPGA disorders were recruited for triptorelin stimulating test.And all patients were followed up for 12 -48 months until a definite diagnosis was made.The values of triptorelin stimulating test in the differential diagnoses of HPGA disorders were assessed by examining the close relationship between LHmax and the final clinical diagnosis.Results (1) LH levels rose steady after an intramuscular injection of triptorelin 100 μg and the time of LHmax appeared at 45 -60min.(2) LHmax ＜4 U/L indicated the function of HPGA was not activated.LHmax in the range of 4 - 12U/L indicated the patients might have constitutional delayed puberty development.LHmax ＞ 12 U/Lindicated the fulfilled puberty development.Conclusion Triptorelin stimulating test can precisely evaluate the functions of HPGA in various HPGA disorders and provide valuable information for the differential diagnoses in constitutional delayed puberty development,hypogonadotropic hypogonadolism,central and peripheral precocious puberty disorders.