Losa M, Alba-Roth J, Sobieszczyk S, Schopohl J, Müller O A, von Werder K
Medizinische Klinik Innenstadt, University of Munich, FRG.
Acta Endocrinol (Copenh). 1989 Mar;120(3):383-9. doi: 10.1530/acta.0.1200383.
We investigated the pattern of GH secretion in response to repetitive TRH administration in patients with active acromegaly and in normal subjects. Nine acromegalic patients and 10 normal subjects received three doses of 200 micrograms of TRH iv at 90-min intervals. There was a marked serum GH rise in acromegalic patients after each TRH dose (net incremental area under the curve [nAUC]: first dose = 4448 +/- 1635 micrograms.min.l-1; second dose = 3647 +/- 1645 micrograms.min.l-1; third dose = 4497 +/- 2416 micrograms.min.l-1; NS), though individual GH responses were very variable. In normal subjects TRH did not elicit GH secretion even after repeated stimulation. Each TRH administration stimulated PRL release in acromegalic patients, though the nAUC of PRL was significantly higher after the first (1260 +/- 249 micrograms.min.l-1) than after the second and the third TRH administration (478 +/- 195 and 615 +/- 117 micrograms.min.l-1, respectively; P less than 0.01). In normal subjects too, PRL secretion was lower after repeated stimulation (first dose = 1712 +/- 438 micrograms.min.l-1; second dose = 797 +/- 177 micrograms.min.l-1; third dose = 903 +/- 229 micrograms.min.l-1 P less than 0.01), though different kinetics of PRL secretion were evident, when compared with acromegalic patients. TSH secretion, assessed in only 4 patients, was stimulated after each TRH dose, though a minimal but significant reduction of nAUC of TSH after repeated TRH challenge occurred. Both T3 and T4 increased steadily in the 4 patients. The same pattern of TSH, T3, and T4 secretion occurred in normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
我们研究了活动性肢端肥大症患者和正常受试者在重复注射促甲状腺激素释放激素（TRH）后生长激素（GH）的分泌模式。9例肢端肥大症患者和10例正常受试者每隔90分钟静脉注射三剂200微克TRH。每次注射TRH后，肢端肥大症患者血清GH均显著升高（曲线下净增量面积[nAUC]：第一剂=4448±1635微克·分钟·升⁻¹；第二剂=3647±1645微克·分钟·升⁻¹；第三剂=4497±2416微克·分钟·升⁻¹；无显著性差异），尽管个体GH反应差异很大。在正常受试者中，即使反复刺激，TRH也不会引起GH分泌。每次注射TRH均刺激肢端肥大症患者催乳素（PRL）释放，不过PRL的nAUC在第一次注射后（1260±249微克·分钟·升⁻¹）显著高于第二次和第三次注射后（分别为478±195和615±117微克·分钟·升⁻¹；P<0.01）。在正常受试者中，反复刺激后PRL分泌也降低（第一剂=1712±438微克·分钟·升⁻¹；第二剂=797±177微克·分钟·升⁻¹；第三剂=903±229微克·分钟·升⁻¹；P<0.01），不过与肢端肥大症患者相比，PRL分泌动力学明显不同。仅在4例患者中评估促甲状腺激素（TSH）分泌，每次注射TRH后TSH均受到刺激，不过在反复TRH刺激后TSH的nAUC出现最小但显著的降低。4例患者的三碘甲状腺原氨酸（T3）和甲状腺素（T4）均稳步升高。正常受试者中TSH、T3和T4的分泌模式相同。（摘要截断于250字）
