促性腺激素释放激素与其类似物用于激发试验的对比观察-内科学专业论文.docxVIP

促性腺激素释放激素与其类似物 用于激发试验的对比观察 研究生：张燕 导师：葛家璞 教授/主任医师 摘 要 目的：本文旨在探讨皮下注射 GnRHa（曲普瑞林）激发试验与传统的静脉推注 GnRH（戈那瑞林）激发试验对正常成人下丘脑-垂体-性腺轴的影响是否具有一致性。 方法：本研究为配对设计，对 符合条件的 67 例受试者在两周内先后进行 GnRH 激发 试验和 GnRHa 激发试验，在用药前 0min 及用药后 15min、30 min、45 min、60 min 、 90 min 及 120min 7 个时间点采血，应用化学发光免疫法测定黄体生成素（LH）和 卵泡刺激素（FSH）。对检测结果比较分析。结果：曲普瑞林和戈那瑞林激发试验七 个时间点的 LH 及 FSH 水平之间存在统计学差异（P=0.000）。对两激发试验同一时 间点的 LH 和 FSH 的水平进行比较，45min、60min、90min 和 120min 四个时间点的 LH 水平存在统计学差异（P=0.047，P=0.003，P=0.000，P=0.000），90min 和 120min 两个时间点的 FSH 水平存在统计学差异（ P=0.013，P=0.002）。戈那瑞林试验中，LH 水平在 30min、45min、60min、90min 及 120min 之间无统计学差异（P0.05），曲普 瑞林试验中 LH 水平在 30min 之前与戈那瑞林无差异，但 45min 至 120min 各参考指 标均明显高于戈那瑞林试验。两试验 FSH 水平在 45min 及 60min 两时间点无统计学 差异（P=0.125）。结论：曲普瑞林能够用于促性腺激素释放激素激发试验，并且两 试验均可以简化为 45min 或 60min 一次采血来对受试者下丘脑-垂体-性腺轴功能进行 评价。 关键词：GnRH 激发试验；GnRHa 激发试验；GnRH 类似物；下丘脑-垂体-性腺轴 To observe the comparison between GnRH and GnRHa in stimulation test Postgraduate:ZhangYan Supervisor: Prof. GeJiapu Abstract Objective ： To find whether there is consistency between Subcutaneous GnRH analogue stimulation test and the traditional intravenous GnRH stimulation test in evaluating the function of hypothalamus - pituitary - gonadal axis of normal adults. Methods ：This is a paired design trial, 67 subjects accepted Gonadorelin IV test firstly, then the Triptorelin Acetate SQ test later，within a 2-week intervals (An average of 9± 3d), seven blood samples were collected in each test, at 0,15,30,45,60,90 and 120min after the drug injection. LH and FSH were assayed by chemiluminometry assay. The results were compared and analysed. Results：There was significantly different (P=0.000) between the LH level and FSH level from seven time points of these two tests. The LH level and FSH level of the same time point were compared between these two tests, the LH level was significantly different (P=0.047, P=0.003, P=0.000, P=0.000) at 45min, 60min, 90min and 120min, the FSH level was significantly different (P=0.013，P=0.002) at 90min and 120m