基础促黄体生成素在监测女童中枢性性早熟治疗中的有效性。
Effectiveness of basal LH in monitoring central precocious puberty treatment in girls.
作者信息
Calcaterra Valeria, De Filippo Gianpaolo, Albertini Riccardo, Rendina Domenico, Messini Beatrice, Monti Claudio Maria, Bozzola Elena, Villani Alberto, Bozzola Mauro
机构信息
Department of Internal Medicine and Therapeutics, Pediatrics and Adolescent Unit, University of Pavia, Pavia, Italy.
Department of Pediatrics, Children's Hospital "V. Buzzi", Milan, Italy.
出版信息
J Pediatr Endocrinol Metab. 2020 Nov 12;34(1):45-50. doi: 10.1515/jpem-2020-0386. Print 2021 Jan 27.
OBJECTIVES
Treatment of central precocious puberty (CPP) is based on administration of GnRH agonists in order to suppress hypothalamic-pituitary-gonadal axis and thus induce the stabilization or regression of pubertal development. Our aim was to determine whether the single basal serum LH and/or FSH concentration could be an effective tool to assess the efficacy of treatment to suppress activation of hypothalamic-pituitary axis.
PATIENTS AND METHODS
Serum LH and FSH were measured before and after the GnRH injection, as well as E2 basal levels in 60 girls with documented idiopathic CPP at diagnosis and 18 and 30 months after the beginning of therapy.
RESULTS
At diagnosis, peaks of >5 IU/L of LH and of FSH were observed in 100 and 91.6% of girls, respectively, with basal LH values of <1 IU/L in 70% and basal FSH levels of <1 IU/L in 10%. E2 were <20 pg/mL in 36.6%. After 18 months, a suppressed peak (i.e. <3 IU/L) was recorded in 85% of girls (p<0.01) for LH and in 98.3% for FSH (p<0.01). Basal LH <1 IU/L was detected in 85% (p<0.01) and basal FSH ≤1 IU/L in 40% (p<0.01). Serum E2 ≤20 pg/mL was recorded in 61.6% (p<0.01). After 30 months, all patients showed LH suppressed peak (p<0.01) and 98.3% suppressed FSH peak (p<0.01). 100% showed basal LH concentrations <1 IU/L (p<0.01) and 38.3% FSH basal values <1 UI/mL (p<0.01). E2 ≤20 pg/mL was observed in 32.72% (p=NS).
CONCLUSIONS
Basal LH values are a reliable indicator of the efficacy of GnRHa therapy after 30 months of GnRHa therapy.
目的
中枢性性早熟（CPP）的治疗基于使用促性腺激素释放激素（GnRH）激动剂，以抑制下丘脑 - 垂体 - 性腺轴，从而诱导青春期发育的稳定或消退。我们的目的是确定单次基础血清促黄体生成素（LH）和/或促卵泡生成素（FSH）浓度是否可作为评估抑制下丘脑 - 垂体轴激活治疗效果的有效工具。
患者与方法
对60例确诊为特发性CPP的女孩在GnRH注射前后测量血清LH和FSH，并在治疗开始后的18个月和30个月测量基础雌二醇（E2）水平。
结果
诊断时，分别有100%和91.6%的女孩LH峰值>5 IU/L和FSH峰值>5 IU/L，70%的女孩基础LH值<1 IU/L，10%的女孩基础FSH水平<1 IU/L。36.6%的女孩E2<20 pg/mL。18个月后，85%的女孩LH出现抑制峰值（即<3 IU/L）（p<0.01），98.3%的女孩FSH出现抑制峰值（p<0.01）。85%的女孩检测到基础LH<1 IU/L（p<0.01），40%的女孩基础FSH≤1 IU/L（p<0.01）。61.6%的女孩血清E2≤20 pg/mL（p<0.01）。30个月后，所有患者LH均出现抑制峰值（p<0.01），98.3%的患者FSH出现抑制峰值（p<0.01）。100%的患者基础LH浓度<1 IU/L（p<0.01），38.3%的患者基础FSH值<1 UI/mL（p<0.01）。32.72%的患者观察到E2≤20 pg/mL（p=无统计学意义）。
结论
GnRHa治疗30个月后，基础LH值是GnRHa治疗效果的可靠指标。
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