左旋多巴、精氨酸和运动激发试验对脑垂体GH分泌的影响  

Effect of Levo-Dopa, Arginine and Exercise on Pituitary Growith Hormone (GH) Secretion

作　　者：李智勇[1] 李兴华[1] 季雪静[1] 昝坤[1] 高莉莉[2] 

机构地区：[1]徐州医学院附属医院核医学科,苏州大学在读硕士研究生221002 [2]徐州医学院附属医院儿科,221002

出　　处：《放射免疫学杂志》2004年第5期338-339,共2页Journal of Radioimmanology

摘　　要：目的 :评价左旋多巴、精氨酸和运动激发试验对矮小症脑垂体生长激素分泌的影响。方法 :用放射免疫分析对 78例矮小症疑诊生长激素缺乏的儿童进行 110次激发前和激发后生长激素检测。以激发试验后测得GH最高值为峰值 ,峰值≥ 5 .0ng/ml为垂体有应答反应 ,≥ 10ng/ml为GH无缺乏 ,记为激发试验阳性 ,<10ng/ml为阴性。 结果 :激发试验峰值出现的时间不同 ,在有应答的病例中 ,GH的峰值强度分别为左旋多巴(14 0 9± 9 6 2 )ng/ml,精氨酸 (13 77± 6 83)ng/ml,运动试验 (12 6 8± 7 81)ng/ml,三者GH峰值间没有显著性差异 (P >0 0 5 )。激发试验的阳性率为左旋多巴 35 71% (15 / 4 2 )、精氨酸 36 36 % (12 / 33)和运动试验14 2 0 % (5 / 35 ) ,左旋多巴、精氨酸激发试验的阳性率明显高于运动试验 ,有显著性差异 (P <0 0 5 ) ,而左旋多巴与精氨酸的阳性率比较没有显著性差异 (P >0 0 5 )。结论 :左旋多巴和精氨酸激发试验有较高的阳性率 ,是良好的刺激药物 ,并且是一种较理想的组合。Objective To assess the stimulation effect on GH secretion with different agents (levo-dopa, arginine, exercise) in dwarf subjects. Methods Growth hormone provocative tests were performed with levo-dopa (42 times), arginine (33) and standardized exercise (35) in 78 subjects classified as dwarfs. Serum GH levels were determined with RIA before the test and several times (at 30 min, intervals) afterwards with the peak value noted. The test resurts were divided into 3 categories: ① peak value<5.0ng/ml, no response at all ② peak value 5～10ng/ml, with response but classificed as test negative ③ peak value>10ng/ml, test positive (no GH deficiency). Results Peak values of serum GH after stimulation test with respective agents were: levo-dopa 14.09±9.62ng/ml, arginine 13.77±6.83ng/ml and exercise 12.68±7.81ng/ml with no significant differences among them. Posititive rate after drug stimulation was significantly higher than that after exercise: levo-dopa 35.71% (15/42), arginine 36.36% (12/33) vs exercise 14.20% (5/35) P<0.05, but there was no significant difference between the positive rates after stimulation with the two drugs (P>0 05). Conclusion Diagnosis of GH deficiency (stimalation test negative) is best established after two negative provocative tests with different stimulant each time. Levo-dopa and argimine may be the drug of choice.

关 键 词：激发试验 左旋多巴 精氨酸 GH 阳性率 运动试验 脑垂体 分泌 缺乏 刺激 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R584[医药卫生—临床医学]