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发育医学电子杂志  2025, Vol. 13 Issue (1): 56-61,65    DOI: 10.3969/j.issn.2095-5340.2025.01.008
  生长发育   论著 |
定量测定尿促性腺激素判断女童性发育的临床应用
余丹 邓茜 王娟娟 高健 陈雨青
安徽省儿童医院 儿童内分泌代谢科,安徽 合肥 230022)
Clinical application of quantitative determination of urinary gonadotropin in judging the sexual development in girls
Yu Dan, Deng Qian, Wang Juanjuan, et al
(Department of Endocrinology and Metabolism in Children, Anhui Provincial Children's Hospital, Anhui, Hefei 230022, China
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摘要 【摘要】 目的  探讨定量测定尿促性腺激素(gonadotropin,Gn),包括尿促黄体生成素(luteinizing hormone,LH)、尿促卵泡刺激素(follicle stimulating hormone,FSH)在判断女童性发育及诊断中枢性性早熟(central precocious puberty,CPP)中的应用价值。 方法 采用回顾性研究方法,选取2021 年12 月
至2022 年10 月因乳房发育于安徽省儿童医院儿童内分泌代谢科住院就诊的72 例女童作为研究对
象。根据促性腺激素释放激素(gonadotropin-releasing hormone,GnRH)激发试验结果将患儿分为CPP
组(n=48)和乳房早发育(premature thelarche,PT)组(n=24)。分析晨尿Gn 浓度及GnRH 激发试验后2 h 内的随机尿Gn 值,以及GnRH 激发试验相关血Gn 值。对2 组患儿血、尿LH 和FSH 值及相关参数的差
异进行比较分析。统计学方法采用t 检验、Mann-whitney U 检验、Spearman 相关性分析和受试者工作
特征(receiver operating characteristic,ROC)曲线分析。 结果  CPP 组与PT 组激发后尿FSH 值[31.09
(24.21,39.18)mIU/ml 与45.67(30.78,60.93)mIU/ml,Z=-2.230,P<0.05] 比较,CPP 组低于PT 组;CPP 组的晨尿及激发后尿LH 值、晨尿和激发后尿LH/FSH 值[1.27(0.66,3.57) mIU/ml、9.44(4.58,20.68) mIU/ml 和0.07(0.04,0.15)、0.22(0.15,0.50)],与PT 组相应指标[0.77(0.60,1.00) mIU/ml、3.71(1.85,6.07) mIU/ml 和0.04(0.03,0.06)、0.08(0.06,0.15)] 比较,CPP 组均高于PT 组,差异均有统计学意义(P 值均<0.05)。Spearman 相关性分析结果显示,晨尿LH 值与血LH 基值(r=0.645,P<0.05)及激发后尿LH 值(r=0.347,P<0.05)呈正相关,激发后尿LH 值与血LH 峰值呈正相关(r=0.385,P<0.05),激发后尿LH/FSH 值与血LH/FSH 峰值比呈正相关(r=0.393,P<0.05)。ROC 曲线分析结果显示,当晨尿LH值≥ 1.12 mIU/ml 时,其诊断CPP 的敏感度为60.0%,特异度为86.4%;激发后尿LH值≥ 8.23 mIU/ml 时,其诊断CPP 的敏感度和特异度分别为53.3% 和95.7%。 结论 检测尿Gn 可以作为一种非侵入性的、简便的诊断方法,对判断女童的性发育有一定的意义。
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关键词:  尿黄体生成素  女童  尿卵泡刺激素  促性腺激素  性早熟    
Abstract: 【Abstract】 Objective To explore the application value of quantitative determination of urinary gonadotropin(Gn), including urinary luteinizing hormone (LH) and urinary follicle stimulating hormone (FSH) in judging thesexual development and the diagnose of central precocious puberty (CPP) in girls. Method From December2021 to October 2022, 72 girls who were hospitalized in the Department of Endocrinology and Metabolismin Children, Anhui Provincial Children's Hospital due to breast development were selected by retrospectivestudy. Based on the results of the gonadotropin-releasing hormone (GnRH) stimulation test, these childrenwere divided into two groups: CPP group (n=48) and premature thelarche (PT) group (n=24). The morningurinary Gn concentration, random urine Gn concentration within 2 hours post-GnRH stimulation test, andblood Gn concentration associated with the GnRH stimulation test were analyzed, and the levels of LH andFSH in blood and urine along with related parameters between two groups were compared and analyzed.Statistical methods performed by t-test, Mann-Whitney U tests, Spearman correlation analysis, and receiveroperating characteristic (ROC) curve analysis. Result Urinary FSH concentrations post-stimulation inCPP group were significantly lower than that in PT group [31.09 (24.21, 39.18) mIU/ml vs 45.67 (30.78,60.93) mIU/ml, Z=-2.230, P<0.05]. Morning urinary and post-stimulation urinary LH, as well as morningurinary and post-stimulation urinary LH/FSH in CPP group were 1.27 (0.66, 3.57) mIU/ml, 9.44 (4.58, 20.68)mIU/ml and 0.07 (0.04, 0.15), 0.22 (0.15, 0.50). Meanwhile, the corresponding indexes in PT group were 0.77(0.60, 1.00) mIU/ml, 3.71 (1.85, 6.07) mIU/ml and 0.04 (0.03, 0.06), 0.08 (0.06, 0.15). The expression levelsof the four indicators in CPP group were higher than those in PT group (all P<0.05). Spearman correlationanalysis showed that morning urinary LH was positively correlated with the blood LH basal value (r=0.645,P<0.05) and urinary LH after stimulation (r=0.347, P<0.05), urinary LH after stimulation was positivelycorrelated with the blood LH peak value (r=0.385, P<0.05), and urinary LH/FSH after stimulation waspositively correlated with blood LH/FSH peak ratio (r=0.393, P<0.05). ROC curve analysis showed that whenthe morning urinary LH was≥1.12 mIU/ml, the sensitivity and specificity of diagnosis for CPP were 60.0% and86.4%. When the urinary LH was≥8.23 mIU/ml after stimulation, the sensitivity and specificity of diagnosis forCPP were 53.3% and 95.7%. Conclusion The detection of urinary Gn can be used as a non-invasive and simple
diagnostic method, which has certain significance in judging the sexual development of girls.
Key words:  Urinary luteinizing hormone    Girl    Urinary follicle stimulating hormone    Gonadotropin    Precocious puberty
收稿日期:  2024-05-30                     发布日期:  2025-01-26     
基金资助: 安徽医科大学校科研基金(2019xkj080)
通讯作者:  陈雨青    E-mail:  894839405@qq.com
引用本文:    
余丹 邓茜 王娟娟 高健 陈雨青. 定量测定尿促性腺激素判断女童性发育的临床应用[J]. 发育医学电子杂志, 2025, 13(1): 56-61,65.
Yu Dan, Deng Qian, Wang Juanjuan, et al. Clinical application of quantitative determination of urinary gonadotropin in judging the sexual development in girls. Journal of Developmental Medicine(Electronic Version), 2025, 13(1): 56-61,65.
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http://www.fyyxzz.com/CN/10.3969/j.issn.2095-5340.2025.01.008  或          http://www.fyyxzz.com/CN/Y2025/V13/I1/56
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