Hanew K, Sato S, Sasaki A, Goh M, Shimizu Y, Murakami O, Yoshinaga K
Tohoku J Exp Med. 1985 Nov;147(3):273-80. doi: 10.1620/tjem.147.273.
We studied here the clinical significance of GHRF test in evaluating therapeutic results in patients with acromegaly. Three cases of acromegaly were studied at pre- and posttreatment. Case 1 is a 42 year old woman, and her plasma GH showed slight increases responding to TRH and arginine administration before therapy. Eleven years after the pituitary irradiation, basal plasma GH decreased to low normal ranges and showed no response to the above two agents. Only an insufficient increase in plasma GH was observed after GHRF injection. This case would have pituitary lesions not only in the tumor somatotrophs but also in the normal somatotrophs. Case 2 is a 38 year old man. His plasma GH showed a marked increase after TRH injection. To GHRF administration, however, no clear response was observed. After transsphenoidal adenomectomy, the aberrant responses to TRH was still observed despite the marked GH decrease to the near normal ranges. Interestingly, plasma GH became responsive to GHRF after the operation. It seems that the adenomectomy was inadequate in this case and the normal somatotrophs recovered the responsiveness to GHRF. Case 3 is a 53 year old woman, and she showed aberrant GH responses to TRH and to L-dopa. Her plasma GH clearly increased after GHRF injection. Postoperatively, the abnormal responses of plasma GH disappeared completely, while a normal GH response was observed following GHRF injection.(ABSTRACT TRUNCATED AT 250 WORDS)
我们在此研究了生长激素释放因子（GHRF）试验在评估肢端肥大症患者治疗效果中的临床意义。对3例肢端肥大症患者在治疗前和治疗后进行了研究。病例1为一名42岁女性，治疗前其血浆生长激素（GH）对促甲状腺激素释放激素（TRH）和精氨酸给药有轻微升高反应。垂体放疗11年后，基础血浆GH降至低正常范围，对上述两种药物无反应。注射GHRF后仅观察到血浆GH升高不足。该病例的垂体病变不仅存在于肿瘤生长激素细胞中，也存在于正常生长激素细胞中。病例2为一名38岁男性。注射TRH后其血浆GH显著升高。然而，给予GHRF后未观察到明显反应。经蝶窦腺瘤切除术后，尽管GH显著下降至接近正常范围，但对TRH的异常反应仍存在。有趣的是，术后血浆GH对GHRF有反应。似乎该病例的腺瘤切除术不彻底，正常生长激素细胞恢复了对GHRF的反应性。病例3为一名53岁女性，她对TRH和左旋多巴表现出异常的GH反应。注射GHRF后其血浆GH明显升高。术后，血浆GH的异常反应完全消失，而注射GHRF后观察到正常的GH反应。（摘要截短于250字）
