简易戈那瑞林激发试验在真性性早熟诊断中的价值探讨

目的:评价简易戈那瑞林激发试验在真性性早熟(CPP)诊断中的价值.方法:对乳房提前发育的292例女孩行戈那瑞林激发试验,根据激发试验结果分为CPP组(151例)、单纯乳房早发育(PT,119例)组和周围性性早熟(PPP,22例)组,并对各组激发试验进行比较和分析.结果:3个时相血清黄体生成素(LH)、促卵泡激素(FSH)浓度,PPP组差异无显著性(P＞0.05);PT组差异有显著性(P＜0.01),其中LH以30 min最高,FSH以60 min最高;CPP差异亦有显著性(P＜0.01),LH、FSH均以30 min最高.以基础LH/FSH>0.2作为诊断CPP标准,其敏感性为48.3%,特异性为69.7%;以15 min、30 min、60 min LH/FSH>0.9作为CPP诊断标准,其敏感性分别为80.1%、68.9%、38.4%,特异性分别为90.8%、96.6%、69.7%.结论:戈那瑞林激发试验后15 min LH/FSH>0.9可以作为鉴别CPP与PT的截定值,可以省略注射后60 min测血清LH和FSH.

Simplified gonadorelin stimulation test in diagnosis of precocious puberty

Objective: To assess the diagnostic value of the simplified gonadorelin stimulation test for precocious puberty. Methods: Two hundred and ninety two girls with signs of advanced breast development received the gonadorelin stimulation test. According to the result of gonadorelin stimulation test, the girls were divided into 3 groups: 151 with central precocious puberty (CPP), 119 with premature thelarche (PT) and 22 with peripheral precocious puberty(PPP). Results: LH or FSH levels at 15 min, 30 min, 60 min in PPP group were not significantly different ( P >0.05). Those were significantly different in PT group ( P <0 01). The highest levels of LH were at 30 min and the highest levels of FSH were at 60 min. LH or FSH levels at 15min, 30min, 60min in CPP group were significantly different ( P <0.01)with the highest levels at 30 min. The ratio of basal LH and FSH>0 2 had a diagnostic sensitivity of 48 3% and specificity of 69 7%. Taking the LH/FSH ratio >0 9 at 15 min, 30 min, 60 min as cut off value, the diagnostic sensitivity was 80 1%, 68 9% and 38 4%, and the specificity was 90 8%, 96 6% and 69 7%, respectively. Conclusion: The LH/FSH ratio >0 9 at 15 min after gonadorelin sti mulation test can be used as a cut off value to differentiate CPP from PT and blood sample at 60 min were not necessary .