Abstract:

Objective    To investigate the value of quantitative assay of urinary gonadotropins （UGn），including ULH and UFSH，in sexual development in girls. Methods    A total of 109 girls with sexual development underwent both GnRH stimulation and UGn assay admitted from October 2013 to February 2015 in Rui Jin Hospital Shanghai Jiao Tong University School of Medicine were analyzed. Two successive morning urine was collected for detection of UGn. On the second day girls underwent conventional GnRH stimulation test while serial blood samples and the total 4-hour urinary sample after GnRH administration was collected for detection of UGn. Results    ①There were no significant differences in UGn concentrations between two consecutive days but UGn was significantly correlated with basic serum Gn. ②Total 4 h UGn  concentrations were significantly correlated with peak value of serum Gn. The ratio of ULH/UFSH was also correlated with ratio of serum LH/FSH. ③The value of assessment for breast development in Tanner stage Ⅱ and Ⅲ was similar by quantitative assays of UGn or serum Gn. ④Determination of basic morning ULH level and total 4 h ULH and the ratio of ULH/UFSH after GnRH stimulation were all helpful for clinical discrimination of PT and CPP. Conclusion    UGn detection is considered as a significant criteria for assessment of activity of HPG axis in children with sexual development，and can be used as a non-invasive and sensitive diagnostic method.

Key words: urinary LH, urinary FSH, gonadotropins, sexual development

摘要：

目的    探讨定量测定尿促性腺激素（UGn），包括尿黄体生成素（ULH）、尿卵泡刺激素（UFSH）在女童性发育中的应用价值。方法    以2013年10月至2015年2月在上海交通大学附属瑞金医院儿内科因乳房发育就诊的109例女童作为研究对象。109例均诊断为性早熟或青春发育提前。收集其就诊第1、2日晨尿，检测UGn浓度。就诊第2日晨采血，行促性腺激素释放激素（GnRH）激发试验，并收集试验后4 h内总尿，测UGn。结果    （1）连续2日晨尿UGn浓度差异无统计学意义，与血Gn基础值显著相关。（2）GnRH激发试验后4 h总尿UGn浓度与血Gn峰值呈显著相关，激发试验后血和尿的LH/FSH比值也呈显著相关。（3）尿、血Gn水平评估Tanner Ⅱ期与Tanner Ⅲ期的价值相似。（4）晨尿ULH、激发后4h总ULH及ULH/UFSH比值有助于临床鉴别乳房早发育（PT）和中枢性性早熟（CPP）。结论    检测UGn对于判断女性儿童性发育程度有一定意义，可作为一种无创而灵敏的诊断方法。

关键词: 尿黄体生成素, 尿卵泡刺激素, 促性腺激素, 性发育