Hilczer Maciej, Smyczynska Joanna, Stawerska Renata, Lewinski Andrzej
Department of Endocrinology and Isotope Therapy, Medical University of Lodz, Poland.
Neuro Endocrinol Lett. 2005 Feb;26(1):19-24.
The aim of the study was an evaluation of final height and growth hormone (GH) secretion after completion of GH therapy (retesting) in patients with GH deficiency (GHD).
The analysis comprised 53 patients (43 boys, 10 girls) with childhood-onset GHD, who completed GH therapy and reached final height. Magnetic resonance imaging (MRI), performed in all the patients, led to the following groups: pituitary stalk interruption syndrome (PSIS), pituitary hypoplasia (HP), craniopharyngioma (CP) -- patients after tumour excision, patients with normal hypothalamic-pituitary region (NP).
In 51 patients, final height was normal. The height gain was significantly (p<0.05) greater in PSIS than in that other groups. In retesting, GH secretion was significantly (p<0.005) lower in PSIS and CP than in HP and in NP and also (p<0.05) in HP than in NP. Permanent severe GHD was confirmed in all the patients with PSIS and CP and in some patients with HP (37.5%), while it was excluded in all the patients with normal pituitary in MRI.
It seems that in patients with PSIS and CP, the confirmation of persistent character of GHD needs no retesting, while in patients with normal MRI results, GHD diagnosis should be established with special attention.
本研究旨在评估生长激素缺乏症（GHD）患者完成生长激素（GH）治疗后（重新检测）的最终身高和GH分泌情况。
分析纳入53例儿童期起病的GHD患者（43例男孩，10例女孩），这些患者完成了GH治疗并达到了最终身高。对所有患者进行了磁共振成像（MRI）检查，结果分为以下几组：垂体柄中断综合征（PSIS）、垂体发育不全（HP）、颅咽管瘤（CP）——肿瘤切除术后患者、下丘脑-垂体区域正常的患者（NP）。
51例患者的最终身高正常。PSIS组的身高增长显著高于其他组（p<0.05）。在重新检测中，PSIS组和CP组的GH分泌显著低于HP组和NP组（p<0.005），HP组也低于NP组（p<0.05）。所有PSIS组和CP组患者以及部分HP组患者（37.5%）确诊为永久性严重GHD，而所有MRI显示垂体正常的患者均排除GHD。
似乎对于PSIS组和CP组患者，无需重新检测即可确认GHD的持续性，而对于MRI结果正常的患者，应特别注意确立GHD诊断。
