下丘脑-垂体-性腺轴功能评估方法在诊断儿童性早熟中的进展
- 李雪宁 综述, 赵亚茹 审校
作者信息
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文章历史
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摘要
下丘脑-垂体-性腺轴(hypothalamic-pituitary-gonadal axis,HPGA)对人体生殖系统的发育、功能状态的维持具有重要的作用,判断 HPGA 功能状态是儿童性发育异常性疾病诊疗路径中的关键步骤之一。目前大家公认的评估儿童 HPGA 功能状态的实验室金标准是经典的促性腺激素释放激素(gonadotropin releasing hormone,GnRH)激发试验,但该试验存在采血次数多、费用较高、操作复杂、患儿及家长依从性差等缺点,使其在临床应用方面受到一定限制。随着促性腺激素(gonadotrophin,Gn)检测技术的发展,检测灵敏度得到了极大提高,为临床及科研工作者寻求更简单、更方便的方法来评估HPGA功能状态创造了条件。本文主要阐述目前在简化GnRH 激发试验以及探索可替代经典的GnRH 激发试验来评估HPGA功能状态的研究现状。
关键词
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参考文献
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[12] Pasternak Y,Friger M,Loewenthal N,et al.The utility of basal serum LH in prediction of central precocious puberty in girls[J].Eur J Endocrinol,2012,166(2):295-299.
[13] Lee HS,Park HK,Ko JH,et al.Utility of basal luteinizing hormone levels for detecting central precocious puberty in girls[J].Horm Metab Res,2012,44(11):851-854.
[14] Neely EK,Hintz RL,Wilson DM,et al.Normal ranges for immunochemiluminometric gonadotropin assays[J].J Pediatr,1995,127(1):40-46.
[15] McNeilly JD,Mason A,Khanna S,et al.Urinary gonadotrophins:a useful non-invasive marker of activation of the hypothalamic pituitary-gonadal axis[J].Int J Pediatr Endocrinol,2012,2012(1):10-20.
[16] Kuijper EA,Houwink EJ,van Weissenbruch MM,et al.Urinary gonadotropin measurements in neonates:a valuable non-invasive method[J].Ann Clin Biochem,2006,43(Pt4):320-322.
[17] 张文杰,徐庄剑,林士霞,等.夜尿促性腺激素与儿童下丘脑-垂体-性腺轴启动的关系[J].实用儿科临床杂志,2010,25(8):561-563.
[18] 张婷婷,徐庄剑,马亚萍,等.夜尿促性腺激素检测对女童性早熟的诊断价值[J].实用临床医药杂志,2012,16(3):47-49,56.
[19] 谢书艳,徐庄剑,马亚萍,等.昼夜尿促性腺激素与儿童下丘脑-垂体-性腺轴启动的关系[J].实用儿科临床杂志,2011,26 (20):1560-1563.
[20] 王喜平,徐庄剑,马亚萍,等.尿促性腺激素检查在儿童促性腺激素释放激素类似物激发试验中的价值[J].实用儿科临床杂志,2010,25(20):1550-1552,1567.
[2] Eckert KL,Wilson DM,Bachrach LH,et al.A single-sample,subcutaneous gonadotropin-releasing hormone test for central precocious puberty[J].Pediatrics,1996,97(4):517-519.
[3] Kim HK,Kee SJ,Seo JY,et al.Gonadotropin-releasing hormone stimulation test for precocious puberty[J].Korean J Lab Med,2011,31(4):244-249.
[4] 刘菁华,田国力,许洪平,等.简易化黄体生成素释放激素激发试验诊断[J].实用儿科临床杂志,2007,22(8):593-594.
[5] 朱帝玲,杨慧明,李晋蓉.简化促性腺激素释放激素激发试验对性早熟的诊断[J].广东医学,2010,31(S):78-80.
[6] Poomthavorn P,Khlairit P,Mahachoklertwattana P.Subcutaneous gonadotropin-releasing hormone agonist (triptorelin) test for diagnosing precocious puberty[J].Horm Res,2009,72(2):114-119.
[7] Houk CP,Kunselman AR,Lee PA.The diagnostic value of a brief GnRH analogue stimulation test in girls with central precocious puberty:a single 30-minute post-stimulation LH sample is adequate[J].J Pediatr Endocrinol Metab,2008,21(12):1113-1118.
[8] Freire AV,Escobar ME,Gryngarten MG,et al.High diagnostic accuracy of subcutaneous Triptorelin test compared with GnRH test for diagnosing central precocious puberty in girls[J].Clin Endocrinol (Oxf),2013,78(3):398-404.
[9] Yazdani P,Lin Y,Raman V,et al.A single sample GnRHa stimulation test in the diagnosis of precocious puberty[J].Int J Pediatr Endocrinol,2012,2012(1):23-30.
[10] Neely EK,Wilson DM,Lee PA,et al.Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty[J].J Pediatr,1995,127(1):47-52.
[11] Houk CP,Kunselman AR,Lee PA,et al.Adequacy of a single unstimulated luteinizing hormone level to diagnose central precocious puberty in girls[J].Pediatrics,2009,123(6):e1059-1063.
[12] Pasternak Y,Friger M,Loewenthal N,et al.The utility of basal serum LH in prediction of central precocious puberty in girls[J].Eur J Endocrinol,2012,166(2):295-299.
[13] Lee HS,Park HK,Ko JH,et al.Utility of basal luteinizing hormone levels for detecting central precocious puberty in girls[J].Horm Metab Res,2012,44(11):851-854.
[14] Neely EK,Hintz RL,Wilson DM,et al.Normal ranges for immunochemiluminometric gonadotropin assays[J].J Pediatr,1995,127(1):40-46.
[15] McNeilly JD,Mason A,Khanna S,et al.Urinary gonadotrophins:a useful non-invasive marker of activation of the hypothalamic pituitary-gonadal axis[J].Int J Pediatr Endocrinol,2012,2012(1):10-20.
[16] Kuijper EA,Houwink EJ,van Weissenbruch MM,et al.Urinary gonadotropin measurements in neonates:a valuable non-invasive method[J].Ann Clin Biochem,2006,43(Pt4):320-322.
[17] 张文杰,徐庄剑,林士霞,等.夜尿促性腺激素与儿童下丘脑-垂体-性腺轴启动的关系[J].实用儿科临床杂志,2010,25(8):561-563.
[18] 张婷婷,徐庄剑,马亚萍,等.夜尿促性腺激素检测对女童性早熟的诊断价值[J].实用临床医药杂志,2012,16(3):47-49,56.
[19] 谢书艳,徐庄剑,马亚萍,等.昼夜尿促性腺激素与儿童下丘脑-垂体-性腺轴启动的关系[J].实用儿科临床杂志,2011,26 (20):1560-1563.
[20] 王喜平,徐庄剑,马亚萍,等.尿促性腺激素检查在儿童促性腺激素释放激素类似物激发试验中的价值[J].实用儿科临床杂志,2010,25(20):1550-1552,1567.
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