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目的探讨皮下注射促性腺激素释放激素类似物(GnRHa)激发试验与传统的静脉推注促性腺激素释放激素(GnRH)激发试验对育龄女性下丘脑-垂体-性腺轴功能的评价是否具有一致性。方法以2010年5月至7月在新疆自治区人民医院进行健康体检的20名20~30岁女性为研究对象,采用配对设计对20名女性先后进行GnRH和GnRHa激发试验,两试验均在用药前及用药后120 min之内的7个时间点采血留取标本,应用化学发光法测定黄体生成素(LH)和卵泡刺激素(FSH)。对检测结果进行比较和分析。结果在GnRH和GnRHa激发试验中,7个时间点之间LH的差异均有统计学意义(U=154.0,P<0.01),FSH的差异也均有统计学意义(U=5.598,P<0.01)。两激发试验得到的相应的7个时点的LH进行比较后可以发现,仅在90 min(P=0.037)及120 min(P=0.013)两个时间点差异有统计学意义;FSH仅在120 min时差异有统计学意义(P=0.017)。结论在育龄女性,GnRHa对LH的影响在0~60 min与GnRH一致,对FSH的影响在0~90 min与GnRH一致。因此,在一定程度上可以替代GnRH用于激发试验,并且可以简化为60 min一次采血激发试验来对受试者下丘脑-垂体-性腺轴功能进行评价。
Objective To investigate whether GnRHa stimulation test and conventional gonadotropin-releasing hormone (GnRH) challenge test have the same effect on hypothalamus-pituitary-gonadal axis function in women of childbearing age. Methods A total of 20 women aged 20-30 years who took physical examination in People’s Hospital of Xinjiang Uygur Autonomous Region from May 2010 to July 2010 were enrolled in this study. 20 women were challenged with GnRH and GnRHa challenged by paired design, And blood samples were collected at 7 time points within 120 min after administration. Luteinizing hormone (LH) and follicle stimulating hormone (FSH) were determined by chemiluminescence. The test results were compared and analyzed. Results There were significant differences in LH between the 7 time points in the GnRH and GnRHa provocation test (U = 154.0, P <0.01), and the differences in FSH were also statistically significant (U = 5.598, P <0.01 ). The comparison of LH at the corresponding seven time points obtained by the two excitation tests showed that the difference was statistically significant only at 90 min (P = 0.037) and 120 min (P = 0.013); FSH was only 120 min difference was statistically significant (P = 0.017). Conclusions In women of childbearing age, the effect of GnRHa on LH is consistent with GnRH at 0-60 min, and the effect on FSH is consistent with GnRH at 0-90 min. Therefore, to some extent, GnRH can be used to stimulate the test, and the test can be simplified to a 60-min one-time blood test to evaluate hypothalamic-pituitary-gonadal axis function.