LHRH激发试验在儿童性早熟诊断及治疗中的应用

目的：观察黄体生成素释放激素（LHRH）激发试验在儿童性早熟诊断及治疗中的作用。方珐：对28例性早熟表现的儿童进行LHRH激发试验，测定LH及FSH值，同时测量身高、骨龄，B超测量子宫及卵巢的容积，结合身高、骨龄、子宫及卵巢容积等将性早熟患儿分真性与假性性早熟组。结果：真性性早熟组8例，假性性早熟组20例，2组LH、FSH基础值比较差异无统计学意义（P〉0．05），而激发后30、60、90minLH差异有统计学意义（P〈0．05）；而FSH在30min差异有统计学意义（P〈0．05），在60、90min差异无统计学意义（P〉0．05）。4例用促性腺激素释放激素（GnRHa）类似物治疗6个月再次做LHRH激发试验，4例治疗后下丘脑-垂体-性腺轴被抑制，LH、FSH呈较低水平。4例真性性早熟患儿治疗前后LH、FSH基础值比较差异无统计学意义（P〉0．05），而激发后30、60、90min差异有统计学意义（P〈0．05）。结论：LHRH激发试验比单次测定LH、FSH更可靠，对性早熟的性质判断及治疗后疗效判断有意义。

Therapeutic and diagnostic application of LHRH stimulation test in precocious puberty

Objectuive:To observe the therapeutic application of luteinizing hormone-releasing hormone (LHRH) stimulation test in precocious puberty. Methods:LHRH stimulation test was performed on 28 children who had the clinical manifestation of precocious puberty.precocious puberty was divided into true precocious puberty and pseudo precocity. Essentials of diagnosis were integration of height, bone age, size of uteres and ovaries with hormonal data such as LH peak serum concentration response to LHRH, >12 mIU/ml (in females ) >25 mIU/ml (in males ) , LH/FSH peak concentration ratio >0. 7, ratio of LH peak serum concentration/basal serum concentration >3. Results: Among 28 patiens, 8 were true precocious puberty, 20 were pseudo precocity. Comparing LH, FSH basal serum concentrations, there was no significant difference, in two groups (P >0. 05). LH serum concentrations respectively, 30, 60, 90 minutes after stimulation with LHRH, there were significant differences between two groups (P<0. 05), FSH serum concentrations, 30 minutes after stimulation with LHRH, there was significant difference between two groups (P<0. 05), FSH serum concentrations respectively 60, 90 minutes after stimulation with LHRH, there is not significant differences between two groups (P>0. 05). In the true precocious puberty group, 4 were given 6 month of GnRH analogs treatment, 6 month later, LHRH stimulation test was performed, as a result of hypothamic- pituitary axis feed back inhibited, LH, FSH response to LHRH stimulation was suppressed, when comparing LH, FSH basal serum concentrations, there were not significant differences pre and post treatment (P>0. 05), 30, 60, 90 minutes after stimulation with LHRH, there were significant differences between two groups (P <0. 05), Conclusion:LHRH stimulation test is more reliable than only measuring levels of LH, FSH, LHRH stimulation test is helpful in judging for types of precocious puberty and evaluate treatment effect after treatment.