标题：中枢性性早熟及外周性性早熟女童的LH、LHRH水平变化及临床意义

      作者：钟剑，魏苗苗，陈书远    惠州市第一人民医院儿科，广东 惠州 516000

      卷次： 2023年34卷3期

      【摘要】 目的 研究中枢性性早熟及外周性性早熟女童的黄体生成素(LH)、黄体生成素释放激素(LHRH)水平变化及临床意义。方法 回顾性分析2018年1月至2021年12月在惠州市第一人民医院儿科诊治的54例性早熟女童的临床资料，按照早熟性质分为中枢性组(中枢性性早熟，35例)与外周性组(外周性性早熟，19例)。采用化学发光免疫法检测所有女童的LH、睾酮(T)、雌二醇(E2)、卵泡刺激素(FSH)水平及LHRH激发试验中的LH、FSH水平，计算并比较两组女童的骨龄指数、子宫容积和卵巢容积。结果 中枢性组女童的LH、FSH水平分别为(4.35±1.54) IU/L、(7.28±2.11) IU/L，明显高于外周性组的(2.34±1.03) IU/L、(4.60±1.32) IU/L，T水平为(12.41±19.22) μg/L，明显低于外周性组的(84.46±123.24) μg/L，差异均有统计学意义(P<0.05)；中枢性组女童的E2水平为(16.73±23.60) ng/L，与外周性组的(32.24±42.24) ng/L比较差异无统计学意义(P>0.05)；LHRH激发试验分别30 min、60 min、90 min，中枢性组女童的 LH水平分别为(19.53±2.66) IU/L、(16.15±2.12) IU/L、(12.45±1.86) IU/L，均明显高于外周性组的(5.65±1.78) IU/L、(5.38±1.40) IU/L、(4.26±1.17) IU/L，差异均有统计学意义(P<0.05)；LHRH激发试验分别 30 min、60 min、90 min，中枢性组女童的FSH水平分别为(15.24±5.28) IU/L、(15.90±5.06) IU/L、(15.99±5.40) IU/L，均明显高于外周性组的(10.96±3.27) IU/L、(11.23±3.74) IU/L、(10.12±3.21) IU/L，差异均有统计学意义(P<0.05)；两组女童的BAI、子宫容积和卵巢容积比较差异均无统计学意义(P>0.05)。结论 中枢性性早熟女童的LH、LHRH水平明显高于外周性性早熟女童，能够通过LH、LHRH水平对两者进行区分。
      【关键词】 中枢性性早熟；外周性性早熟；黄体生成素；黄体生成素释放激素；临床意义
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2023）03—0364—04

Changes and clinical significance of LH and LHRH levels in girls with central precocious puberty and those withperipheral precocious puberty.
ZHONG Jian, WEI Miao-miao, CHEN Shu-yuan. Department of Pediatrics, HuizhouFirst People's Hospital, Huizhou 516000, Guangdong, CHINA
【Abstract】 Objective To study the changes of luteinizing hormone (LH) and luteinizing hormone releasinghormone (LHRH) levels and their clinical significance in girls with central precocious puberty and those with peripheralprecocious puberty. Methods The clinical data of 54 precocious girls treated in Department of Pediatrics, HuizhouFirst People's Hospital from January 2018 to December 2021 were retrospectively analyzed. According to the precociousnature, they were divided into central precocious group (central precocious, 35 cases) and peripheral precocious group(peripheral precocious, 19 cases). The levels of LH, testosterone (T), estradiol (E2), follicle stimulating hormone (FSH),and LH and FSH in LHRH stimulation test were detected by chemiluminescence immunoassay, and the bone age index,uterine volume and ovarian volume were calculated and compared. Results The LH and FSH levels of children in thecentral precocious group were (4.35±1.54) IU/L and (7.28±2.11) IU/L, which were significantly higher than (2.34±1.03)IU/L and (4.60±1.32) IU/L in the peripheral precocious group, T level was (12.41±19.22) μg/L, significantly lower than(84.46±123.24) μg/L in the peripheral precocious group (P<0.05). The E2 level of the children in the central precociousgroup was (16.73±23.60) ng/L, versus (32.24±42.24) ng/L in the peripheral precocious group, and the difference was notstatistically significant (P>0.05). At 30 minutes, 60 minutes, and 90 minutes of the LHRH stimulation test, the LH levelsof children in the central precocious group were (19.53±2.66) IU/L, (16.15±2.12) IU/L, and (12.45±1.86) IU/L, whichwere significantly higher than (5.65±1.78) IU/L, (5.38±1.40) IU/L, (4.26±1.17) IU/L in the peripheral precocious group(P<0.05). At 30 minutes, 60 minutes, and 90 minutes of the LHRH stimulation test, the FSH levels of children in the centralprecocious group were (15.24±5.28) IU/L, (15.90±5.06) IU/L, and (15.99±5.40) IU/L, which were significantly higher than(10.96±3.27) IU/L, (11.23±3.74) IU/L, (10.12±3.21) IU/L in the peripheral precocious group (P<0.05). There were no sig-nificant difference in BAI, uterine volume, and ovarian volume between the two groups (P>0.05). Conclusion The lev-els of LH and LHRH in children with central precocious puberty were significantly higher than those in peripheral preco-cious puberty, which could be differentiated by LH and LHRH levels.
      【Key words】 Central precocious puberty; Peripheral precocious puberty; Luteinizing hormone; Luteinizing hor-mone releasing hormone; Clinical significance