夜尿促性腺激素检测对女童性早熟的诊断价值  

Nocturnal urinary gonadotropin in diagnosis of precocious puberty in girls

作　　者：张婷婷[1] 徐庄剑[1] 马亚萍[1] 王京力[1] 赵金玲[1] 卢隽滢[1] 

机构地区：[1]苏州大学附属第四医院儿科,江苏无锡214062

出　　处：《实用临床医药杂志》2012年第3期47-49,56,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨免疫化学放光法检测夜尿促性腺激素(Gn)检测对女童性早熟的诊断价值。方法性早熟女童63例,其中中枢性性早熟(CPP)42例,非CPP 21例,均住院行促性腺激素释放激素类似物激发试验。激发试验前留取夜间12 h尿作为自发性夜尿Gn标本,并计尿量;激发试验0 min与前夜间00:00血,分别作为自发性昼夜血Gn标本。应用免疫化学发光法检测血和尿中的促黄体生成素(LH)和卵泡刺激素(FSH)。结果自发性夜尿LH含量与血LH峰值(PLH)的相关系数(r)为0.597(P<0.001)。自发性昼夜血LH与PLH的r分别为0.514(P<0.001)和0.423(P<0.01)。自发性夜尿LH含量、自发性日间血LH和自发性夜间血LH的判断CPP的受试者工作特性曲线下面积分别为0.825、0.680和0.654。当自发性夜尿LH含量≥0.113 IU时,判断CPP的灵敏度和特异度分别为71.4%和90.5%。结论应用免疫化学发光法检测的自发性夜间12h尿LH含量对女童CPP具有筛查价值,其临床价值可能优于自发性血LH。Objective To assess the diagnostic value of the nocturnal urinary gonadotropin for precocious puberty in girls.Methods Sixty-three girls with precocious puberty,in which 42 girls had central precocious puberty and other 21 girls had non-CPP,were hospitalized for gonadotropin releasing hormone analogue stimulating test.Nocturnal spontaneous urine was collected at 12 h as Gn samples before the test.Urine amount was also recorded.Serum samples,which were obtained at midnight before the test and 0min during the test,were respectively regarded as the samples of spontaneous nocturnal and diurnal gonadotropin.Luteinizing hormone（LH） and follicle-stimulating hormone（FSH） in serum and urine were examined by immunochemiluminometric assay.Results The correlation coefficient between the urinary LH quantity（concentration×volume） and serum peak LH（PLH） was 0.597（P〈0.001）,for diurnal spontaneous serum LH and PLH 0.514（P〈0.001）,for nocturnal spontaneous serum LH and PLH 0.423（P〈0.01）.The areas under the receiver operator characteristic curves of urinary LH quantity,diurnal spontaneous serum LH,nocturnal spontaneous serum LH for the diagnoses of CPP were 0.825,0.680 and 0.654,respectively.The sensitivity and specificity for the diagnoses of CPP were 71.4% and 90.5% respectively when urinary LH quantity was not less than 0.113 IU.Conclusion Noninvasive determination of timed 12-hour nocturnal spontaneous urinary gonadotropin by immunochemiluminometric assay can be used as a screening tool for CPP in girls.The value of nocturnal urinary LH quantity may be higher than that of spontaneous LH.

关 键 词：尿促性腺激素 性早熟 免疫化学发光法 

分 类 号：R446.122[医药卫生—诊断学]