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生长激素缺乏儿童血浆生长激素对生长激素释放因子的反应缺陷。

Defective response of plasma growth hormone to growth hormone releasing factor in growth hormone deficient children.

作者信息

Ko F Y, Chen W P, Lin C Y

机构信息

Department of Pediatrics, Veterans General Hospital, Taipei, Taiwan, R.O.C.

出版信息

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1992 Jul-Aug;33(4):243-50.

PMID:1296432
Abstract

In an attempt to establish the reference pattern and the plasma growth hormone (GH) response to growth hormone releasing factor (GRF) (1-29)NH2, 5 normal stature with single kidney children and 14 with idiopathic GH deficient dwarfism received intravenous injections of 1 microgram/kg GRF(1-29)NH2. Plasma GH levels were measured at 0, 15, 30, 45, 60, 90, and 120 min after injection. The results showed that, first, in normal stature with single kidney children, each plasma GH reached peak level (80.31 +/- 19.28 ng/ml) at 45 min after injection. Second, the majority of those with GH deficient dwarfism also obtained maximal GH levels (13.10 +/- 10.78 ng/ml) at 45 min after injection but at significantly lower levels than the normal children (P < 0.01). To compare with that obtained after the insulin-induced hypoglycemia test, the peak GH level after GRF was higher but there was no significant correlation between them. The maximal GH level after GRF(1-29)NH2 injection did not show significant correlation with either chronological age or bone age. Third, 3 of 14 (21.4%) with GH deficient dwarfism had half response to GRF(1-29)NH2. It is reasonable to assume that out of these patients' GH deficiency is of hypothalamic origin. Therefore, GRF test is a safe and useful test for differential diagnosis of defect level in GH deficiency and may become a therapeutic regimen.

摘要

为了建立生长激素释放因子(GRF)(1 - 29)NH₂刺激后的参考模式及血浆生长激素(GH)反应,对5名单肾正常身高儿童和14名特发性生长激素缺乏性侏儒症患儿静脉注射1微克/千克GRF(1 - 29)NH₂。于注射后0、15、30、45、60、90和120分钟测定血浆GH水平。结果显示,其一,单肾正常身高儿童,注射后45分钟时各血浆GH均达到峰值水平(80.31±19.28纳克/毫升)。其二,大多数生长激素缺乏性侏儒症患儿在注射后45分钟时也获得了最大GH水平(13.10±10.78纳克/毫升),但明显低于正常儿童(P<0.01)。与胰岛素诱导低血糖试验后的结果相比,GRF刺激后的峰值GH水平更高,但两者之间无显著相关性。GRF(1 - 29)NH₂注射后的最大GH水平与实际年龄或骨龄均无显著相关性。其三,14名生长激素缺乏性侏儒症患儿中有3名(21.4%)对GRF(1 - 29)NH₂呈半反应。可以合理推测,这些患者中部分人的生长激素缺乏源于下丘脑。因此,GRF试验是一种安全且有用的试验,可用于鉴别生长激素缺乏的缺陷水平,且可能成为一种治疗方案。

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