生长激素激发试验在矮小症儿童诊断中的价值及可能影响因素  

Diagnostic value of growth hormone stimulating test in dwarfism of children and related influencing factors

作　　者：林祥泉[1] 袁欣[1] 

机构地区：[1]福建省福州儿童医院/福建医科大学教学医院,福建福州350005

出　　处：《国际检验医学杂志》2015年第8期1036-1037,1040,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨生长激素（GH）激发试验对矮小症儿童的诊断价值及可能影响因素。方法对642例矮小症儿童进行精氨酸和左旋多巴联合GH激发试验,测定激发后30、60、90、120、150、180min GH水平。将患儿分为GH缺乏症（GHD）组（GH峰值小于10ng/mL）和非GHD组（GH峰值大于或等于10ng/mL）,比较两组患儿体格及实验室检测指标。结果共检出GHD患儿441例（68.69%）,非GHD患儿201例（31.31%）,两组患儿所占比例比较差异有统计学意义（χ^2=6.19,P〈0.05）。GH峰值出现时间以30、150min相对较多,分别占22.42%和34.27%,峰值有延后现象。GHD组与非GHD组患儿年龄、身高标准差、体质量指数、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、胰岛素样生长因子1和25-羟维生素D水平比较差异有统计学意义（P〈0.05）。结论精氨酸和左旋多巴联合激发试验可作为矮小症儿童GH缺乏的诊断试验;GH水平与多种体格和实验室检测指标有关,诊断GHD需综合考虑相关影响因素。Objective To investigate the diagnostic value of growth hormone（GH） stimulating test in dwarfism of children and related influencing factors .Methods Arginine and L‐dopa were applied to perform GH stimulating test in 642 children with dwarf‐ism .GH levels were detected at 30 ,60 ,90 ,120 ,150 ,180 min after stimulation .All children were divided into GH deficiency （GHD） group ,with peak value of GH less than 10 ng/mL ,and non‐GHD group ,with peak value of GH at least 10 ng/mL .Physical and la‐boratory data of the two groups were compared .Results The proportion of children with GHD and without GHD were 68 .69%and 31 .31% ,respectively ,and with statistical difference（χ^2 =6 .19 ,P〈0 .05） .The GH peak value ,with a delay ,mainly appeared at 30 and 150 min after stimulation ,accounting for 22 .42% and 34 .27% .Levels of age ,body height standard deviation ,body mass in‐dex ,alanine aminotransferase ,aspartate aminotransferase ,insulin growth factor‐1 and 25‐hydroxyl vitamin D were statistically dif‐ferent between the two groups（P〈0 .05） .Conclusion Arginine and L‐dopa combined stimulating test could be used for the diagno‐sis of GHD in children with dwarfism .GH level might be correlated with various physical and laboratory parameters ,which should be considered for the diagnosis of GHD .

关 键 词：矮小症 激发试验 胰岛素样生长因子1 25-羟维生素D 

分 类 号：R725.8[医药卫生—儿科]