摘要
目的探讨曲普瑞林(促性腺激素释放激素类似物)激发试验在女童曲普瑞林疗效评估中的价值。方法女童31例。其中中枢性性早熟26/31例,采用曲普瑞林(商品名达菲林)治疗;青春期预测终身高矮小4/31例和青春期特发性矮小1/31例,均予以曲普瑞林联合生长激素治疗。曲普瑞林治疗前及治疗3个月(注射下一次曲普瑞林前)均行曲普瑞林激发试验(达必佳,晨起830,每次0.1 mg,皮下注射),注射曲普瑞林0 min血样作为日间自发性促性腺激素(Gn)标本,另采集注射前夜0000血样作为夜间自发Gn标本。应用免疫化学发光分析法(ICMA)检测促黄体生成素(LH)和卵泡刺激素(FSH)水平。结果 30/31例女童曲普瑞林治疗有效,治疗后LH峰值(PLH)最大值为1.68 IU·L-1;1/31例疗效不佳,治疗后PLH为3.81 IU·L-1。在30例治疗有效患儿中,曲普瑞林治疗后PLH[(0.98±0.39)IU·L-1]明显低于其治疗前[(26.11±16.59)IU·L-1](P=0.000),治疗后FSH峰值(PFSH)[(1.65±0.85)IU·L-1]也明显低于其治疗前[(17.78±7.09)IU·L-1](P=0.000),治疗前后PLH和PFSH均无重叠性;治疗后日间自发性LH[(0.47±0.25)IU·L-1]低于其治疗前[(1.88±3.24)IU·L-1](P=0.000),日间自发性FSH[(1.12±0.56)IU·L-1]也低于其治疗前[(5.28±4.49)IU·L-1](P=0.000)。22/30例治疗后夜间自发性LH[(0.48±0.27)IU·L-1]低于其治疗前[(4.55±4.54)IU·L-1](P=0.000),夜间自发性FSH[(1.16±0.47)IU·L-1]也低于其治疗前[(5.34±2.63)IU·L-1](P=0.000)。结论单次自发性Gn检测对生长或发育异常女童曲普瑞林疗效具有初步评估价值,曲普瑞林激发试验(ICMA检测法)可作为女童曲普瑞林疗效评估的可靠检测方法。
Objective To determine the value of triptorelin（ gonadotropin-releasing hormone analogue） stimulation test in monitoring triptorelin therapy for girls. Methods Thirty - one girls were recruited for this study, among whom 26 eases who suffered with central preco-cious puberty were treated with triptorelin（diphereline） ;and the other 5 cases of puberty（4 cases with short stature of predicted adult height and 1 case with idiopathic short stature） were treated with growth hormone co - treatment within triptorelin. Triptorelin stimulation test （ de- eapeptyl,8 ： 30 AM,0.1 mg,s. e. ） was performed before the initiation of treatment as well as 3 months after the beginning of therapy. The 0 rain serum sample collected during the test was for diurnal serum spontaneous gonadotropin detection, and the sample collected at midnight be- fore the test was for nocturnal serum spontaneous gonadotropin detection. Luteinizing hormone （LH） and follicle-stimulating hormone （FSH） in serum were assayed by immunochemiluminometric assays（ICMA）. Results Thirty in 31 cases had good clinical efficacy and the maximum of peak LH（PLH） after triptorelin therapy was 1.68 IU · L^-1. And the other 1 case in 31 cases had poor clinical efficacy and her PLH after the therapy was 3.81 IU · L^-1. In these 30 cases with good efficacy, PLH after and before triptorelin therapy were respectively（0.98 ± 0.39 ）IU · L^-1 and （26.11 ± 16.59 ）IU · L^-1 ], and the former was significantly lower than the latter, P = O. 000 ; and peak FSH （PFSH） after and before triptorelin therapy were respectively （ 1.65 ± 0.85 ） IU · L^-1] and （ 17.78 ± 7.09 ）IU · L^-1, and the former was significantly lower than the latter,P = 0. 000. There was no overlap between minimum PLH before therapy and maximum PLH after therapy, so did between minimum PFSH before therapy and maximum PFSH after therapy. Diurnal spontaneous LH after and before triptorelin therapy were respectively （0.47 ± 0. 25 ） IU · L^-1 and（ 1.88 ± 3.24） IU · L^-1, p = 0. 000 ; and diurnal spontaneous FSH after and before the therapy were respectively （ 1.12 ± 0.56） IU · L^-1 and （ 5.28 ± 4.49 ） IU · L^-1, P = 0. 000. In 22/30 cases with good efficacy, nocturnal spontaneous LH after the triptorelin therapy （ 0.48 ± 0 27 ） IU · L^-1 was lower than that before the therapy [ （4.55 ± 4.54 ） IU · L^-1] （ p =0. 000 ） ; nocturnal spontaneous FSH after the triptorelin therapy（ 1.16±0.47）IU · L^-1 was lower than that before the therapy [ （5.34 ± 2.63 ）IU · L^-1] （ P = 0. 000）. Conclu-sions A single serum sample for spontaneous gonadotropin determination can be used in preliminary assessment of the efficacy of triptorelin therapy for girls, and triptorelin stimulation test（ICMA） may be of usefulness in monitoring triptorelin therapy for girls.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第20期1579-1581,1599,共4页
Journal of Applied Clinical Pediatrics
