目的 探讨胶体金法与化学发光法检测晨尿促性腺激素（gonadotropin, Gn）在评估儿童青春发育状态中的应用。 方法 以2021年11月—2022年12月在上海交通大学医学院附属瑞金医院儿内科确诊为中枢性性早熟（central precocious puberty, CPP）、快速进展型早发育（early and fast puberty, EFP）及乳房早发育（premature thelarche, PT）的132例患儿和同期在该院儿童保健科健康体检的685例健康儿童为研究对象。132例患儿均行促性腺激素释放激素（gonadotropin-releasing hormone, GnRH）激发试验。患儿及健康儿童均采用胶体金法及化学发光法测定尿Gn水平，包括黄体生成素（lutropin hormone, LH）和卵泡刺激素（follicle-stimulating hormone, FSH）水平。分析血清Gn与上述两种方法检测的尿Gn的相关性，以及健康儿童Tanner分期与尿Gn的相关性。 结果 胶体金法和化学发光法检测尿Gn与血清LH基础值、LH峰值、基础LH/FSH比值、LH/FSH峰值比均呈正相关（P<0.05）。在健康儿童中使用化学发光法检测尿LH水平从Tanner Ⅰ~Ⅳ期逐渐升高（P<0.05），尿FSH水平在Tanner Ⅰ期低于Tanner Ⅱ、Ⅲ、Ⅳ期（P<0.05）；使用胶体金法检测尿LH水平在Tanner Ⅰ期低于Tanner Ⅱ、Ⅲ、Ⅳ期，Tanner Ⅳ期高于各期（P<0.05），尿FSH水平在Tanner Ⅲ期高于Tanner Ⅰ、Ⅱ期（P<0.05）。化学发光法检测尿LH、FSH水平以及胶体金法检测尿LH水平评估健康儿童Tanner Ⅰ、Ⅱ期的受试者操作特征曲线的曲线下面积分别为0.730、0.699和0.783。 结论 胶体金法与化学发光法检测晨尿Gn与血清Gn相关性良好；作为一种无创、便捷的检测手段，胶体金法检测尿Gn可作为儿童青春发育启动筛查的手段。
Abstract
Objective To explore the application of the colloidal gold method and chemiluminescence method in detecting gonadotropin (Gn) in morning urine for assessing pubertal development status in children. Methods A total of 132 children diagnosed with central precocious puberty (CPP), early and fast puberty (EFP), and premature thelarche (PT) at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from November 2021 to December 2022 were included, along with 685 healthy children who underwent routine health examinations at the hospital's pediatric health care department during the same period. All 132 patients underwent a gonadotropin-releasing hormone (GnRH) stimulation test. Both patients and healthy children had their urinary Gn levels measured using the colloidal gold method and chemiluminescence method, including levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). The correlation between serum Gn and urinary Gn detected by the two methods, as well as the correlation between Tanner stages of healthy children and urinary Gn, was analyzed. Results Urine Gn levels detected by both the colloidal gold method and chemiluminescence method showed a positive correlation with serum LH baseline values, LH peak values, baseline LH/FSH ratios, and peak LH/FSH ratios (P<0.05). In healthy children, urinary LH levels detected by the chemiluminescence method gradually increased from Tanner stage Ⅰ to Ⅳ (P<0.05), while urinary FSH levels were lower in Tanner stage I than in stages Ⅱ, Ⅲ, and IV (P<0.05). Urinary LH levels detected by the colloidal gold method were lower in Tanner stage I compared to stages Ⅱ, Ⅲ, and IV, with the highest levels observed in Tanner stage Ⅳ (P<0.05). Additionally, urinary FSH levels in Tanner stage Ⅲ were higher than in stages Ⅰ and Ⅱ (P<0.05). The area under the receiver operating characteristic curve for evaluating Tanner stages I and II in healthy children using urinary LH and FSH levels by the chemiluminescence method and urinary LH levels by the colloidal gold method were 0.730, 0.699, and 0.783, respectively. Conclusions The colloidal gold method and chemiluminescence method for detecting Gn in morning urine show good correlation with serum Gn levels. As a non-invasive and convenient detection method, the colloidal gold method can serve as a useful tool for screening the onset of pubertal development in children.
关键词
中枢性性早熟 /
胶体金法 /
化学发光法 /
促性腺激素 /
青春发育 /
儿童
Key words
Central precocious puberty /
Colloidal gold method /
Chemiluminescence method /
Gonadotropin /
Pubertal development /
Child
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