生长激素激发试验在矮小儿童临床诊断中的价值

目的探讨生长激素激发试验在矮小儿童临床诊断中的价值。 方法回顾性分析济宁医学院附属医院内分泌科2013年2月至2014年4月诊治的243例矮小症儿童的临床资料，均行左旋多巴、胰岛素生长激素激发试验，测定生长激素基础值及用药后30、60、90及120min时生长激素水平。采用SPSS 17.0统计软件进行统计学分析，药物激发生长激素峰值强度结果以均数±标准差表示，采用t检验；病因分布计数资料采用四格表χ²检验。 结果68例(27.98%)患儿生长激素完全缺乏，98例(40.33%)部分缺乏，66例(27.16%)为特发性矮小，先天性卵巢发育不全(Turner综合征)7例，占2.88%，其他4例(1.65%)；生长激素缺乏占病因的首位，与完全不缺乏比较，差异有统计学意义(χ²＝6.533，P<0.05)。左旋多巴激发试验生长激素峰值为(6.39±3.81)μg/L，高于胰岛素低血糖激发试验生长激素峰值为(5.02±3.57)μg/L，但差异无统计学意义( t＝1.640，P>0.05)；左旋多巴激发试验生长激素峰值出现时间为60min时119例，48.97%，胰岛素激发试验生长激素峰值出现时间为30min、60min，分别为113例(46.5%)、121例(49.8%)。 结论左旋多巴与胰岛素激发试验可作为矮小症患儿生长激素缺乏的诊断试验。

Clinical significance of the provocative GH testing in clinical diagnosis of short children

ObjectiveTo explore clinical significance of the provocative GH testing in clinical diagnosis of short children. MethodsRetrospective analysis of two hundred and forty-three cases of short children from February 2013 to April 2014, who were tested with levodopa and insulin test.Determing growth basic values and growth values after 30, 60, 90, 120min of giving medicine. ResultsSixty-eight cases(27.98%) with complete lack of growth hormone, ninty-eight patients (40.33%) with partial growth hormone deficiency, sixty-six cases (27.16%) with idiopathic short stature, seven cases (2.88%) with Turner syndrome, four cases with other causes (1.65%). Growth hormone deficiencies was the first cause.Comparing with the partial growth hormone deficiency, there was a significant difference(χ²=6.533, P<0.05). The peak(6.39±3.81)μg/L of growth hormone in L-dopa provocation tests was higher than the peak of growth hormone (5.02±3.57)μg/L in insulin provocation tests, but there was no statistically significant difference (t=1.640, P>0.05); The peak of growth hormone in L-dopa provocation tests appeared in 60min, (one hundred and nineteen cases, 48.97%), the peak of growth hormone in insulin stimulates test in 30min, 60min respectively (one hundred and thirteen cases, 46.50%; one hundred and twenty-one cases, 49.80%). ConclusionProvocation GH testing of levodopa and insulin can be used as diagnostic test of short children with growth hormone deficiency.