Eckert K L, Wilson D M, Bachrach L K, Anhalt H, Habiby R L, Olney R C, Hintz R L, Neely E K
Division of Pediatric Endocrinology, Stanford University Hospital, Stanford, California 94305, USA.
Pediatrics. 1996 Apr;97(4):517-9.
We compared a rapid, subcutaneous (SQ), single-sample gonadotropin-releasing hormone (GnRH) stimulation test with the standard multiple-sample, intravenous (IV) GnRH stimulation test used in the evaluation of central precocious puberty (CPP).
We evaluated 22 patients presenting with evidence of precocious puberty. GnRH (100 microg) was administered subcutaneously in the clinic setting with single serum luteinizing hormone (LH) measured 40 minutes after injection. A standard IV GnRH stimulation test was performed within 2 weeks, with serum LH obtained at 0, 20, 40, and 60 minutes. LH was assayed by immunochemiluminometric assay.
The mean peak LH levels after IV and SQ testing were identical. A significant correlation (r = .88) was found between the LH determined by SQ stimulations and the peak LH determined by IV GnRH testing. CPP was diagnosed (LH, >/- 8 IU/L) by both SQ and IV testing in 7 of 22 patients and was excluded by both tests in 14 of 22 patients. A diagnostic discrepancy between peak IV and SQ results was seen in 1 patient.
We conclude that mean GnRH-stimulated LH levels from rapid SQ and standard IV testing are indistinguishable and that individual LH levels by each method are strongly correlated. A rapid SQ GnRH test is a valid tool for laboratory confirmation of CPP.
我们将一种快速的皮下（SQ）单样本促性腺激素释放激素（GnRH）刺激试验与用于评估中枢性性早熟（CPP）的标准多样本静脉（IV）GnRH刺激试验进行了比较。
我们评估了22例有性早熟证据的患者。在临床环境中皮下注射GnRH（100微克），注射后40分钟测量单次血清促黄体生成素（LH）。在2周内进行标准的静脉GnRH刺激试验，在0、20、40和60分钟时获取血清LH。通过免疫化学发光分析法测定LH。
静脉注射和皮下注射测试后的平均LH峰值水平相同。皮下刺激测定的LH与静脉GnRH测试测定的LH峰值之间存在显著相关性（r = 0.88）。22例患者中有7例通过皮下注射和静脉注射测试均诊断为CPP（LH，>/- 8 IU/L），22例患者中有14例通过两种测试均排除了CPP。1例患者的静脉注射和皮下注射峰值结果存在诊断差异。
我们得出结论，快速皮下注射和标准静脉注射测试中GnRH刺激的平均LH水平无法区分，并且每种方法的个体LH水平密切相关。快速皮下GnRH试验是实验室确诊CPP的有效工具。
