Petrescu Simona, Trifanescu Raluca, Ionescu Petru, Vanghelie Gina Doinita, Tanasescu Radu, Moldovan Mircea, Munjev Nicolae, Bajenaru Ovidiu, Panea Cristina
Elias Emergency University Hospital, Department of Neurology, Bucharest, Romania.
Maedica (Bucur). 2013 Mar;8(1):11-6.
Our objective was to assess the dynamic serum growth hormone (GH) response to clonidine administration in multiple sclerosis patients, looking for a possible biomarker of degenerative process and to correlative with disability.
21 patients with relapsing remitting multiple sclerosis, who were evaluated clinically by expanded disability status scale (EDSS) score and multiple sclerosis functional composite (MSFC) score and for whom we measured the GH before and one hour after oral clonidine administration.Different cut-off values of EDSS score were chosen for observation of GH serum dynamics after clonidine administration. All patients had normal IGF1 values.
There was a significant positive correlation between EDSS and time to walk 25 feet (r = 0.5, p = 0.002) and EDSS and nine holes peg tests for dominant and non dominant hands (r = 0.37, p = 0.024 and r = 0.53, p = 0.001, respectively).There was a moderate negative correlation, significant statistically, between EDSS and paced auditory serial additional test (PASAT) (r= -0.36, p= 0.046).4 out of 7 patients with EDSS score over 3.0 failed to increase serum GH levels after clonidine administration, as compared to 4 out of 14 patients with EDSS < 3 (r = 1.6; p=0.02), revealed by means of the Pearson chi square test.
Despite the small number of subjects enrolled in this pilot study, there is a tendency of blunted GH response in patients with more severe physical disability (stated by an increased value of EDSS), suggesting that GH response to clonidine could assess central autonomic dysfunction in MS patients.
我们的目的是评估多发性硬化症患者服用可乐定后血清生长激素（GH）的动态反应，寻找可能的退行性病变生物标志物，并将其与残疾情况相关联。
21例复发缓解型多发性硬化症患者，通过扩展残疾状态量表（EDSS）评分和多发性硬化症功能综合评分（MSFC）进行临床评估，并在口服可乐定前及服药后1小时测量其GH水平。选择不同的EDSS评分临界值，以观察服用可乐定后GH血清动力学变化。所有患者的胰岛素样生长因子1（IGF1）值均正常。
EDSS与25英尺步行时间之间存在显著正相关（r = 0.5，p = 0.002），EDSS与优势手和非优势手的九孔插针试验之间也存在显著正相关（分别为r = 0.37，p = 0.024和r = 0.53，p = 0.001）。EDSS与听觉连续加法试验（PASAT）之间存在中度负相关，具有统计学意义（r = -0.36，p = 0.046）。通过Pearson卡方检验发现，EDSS评分超过3.0的7例患者中，有4例在服用可乐定后血清GH水平未升高，而EDSS < 3的14例患者中有4例出现这种情况（r = 1.6；p = 0.02）。
尽管本初步研究纳入的受试者数量较少，但身体残疾程度较重（由EDSS值升高表明）的患者存在GH反应迟钝的趋势，这表明可乐定刺激的GH反应可能有助于评估MS患者的中枢自主神经功能障碍。
