Liberman B, Cesar F P, Wajchenberg B L
Clin Endocrinol (Oxf). 1979 Jun;10(6):649-54. doi: 10.1111/j.1365-2265.1979.tb02123.x.
Forty-eight normal volunteers, thirteen subjects with short stature without apparent cause and thirty-one patients with delayed growth clinically highly suggestive of growth hormone deficiency (GHD), with chronological ages of 11.4 +/- 0.4 years (mean +/- SEM), 14.0 +/- 0.7 years and 12.8 +/- 0.8 years; height age of 11.0 +/- 0.4 years, 8.9 +/- 0.7 years and 6.3 +/- 0.4 years and bone age of 10.7 +/- 0.7 years, 9.9 +/- 0.8 years and 7.5 +/- 0.7 years respectively, were tested with provocative tests of human growth hormone (hGH) release-insulin-induced hypoglycaemia, arginine infusion, L-DOPA, exercise and sequential exercise and L-DOPA--in order to identify growth hormone deficiency. In the 'normal' subjects (control plus short stature) the sequential exercise and L-DOPA test induced the greatest peak and integrated secretion rates of plasma hGH (16.5 +- 1.2 ng/ml and 679 +/- 70 ng/ml/120 min respectively) when compared to other tests. This combined stumulus was the only one to which all 'normal' subjects responded: a similar degree of responsiveness has not been earlier described for other hGH-stimuli. The responses observed with all stimuli were significantly lower (P less than 0.001) in GHD group compared to the 'normal subjects'. Emphasis was given to the sequential exercise and L-DOPA test as an innocuous, sensitive and simplified procedure in the evaluation of children with growth retardation.
48名正常志愿者、13名无明显病因的身材矮小受试者以及31名临床上高度提示生长激素缺乏（GHD）的生长发育迟缓患者接受了生长激素（hGH）释放激发试验，包括胰岛素诱发低血糖、精氨酸输注、左旋多巴、运动以及连续运动和左旋多巴试验，以确定生长激素缺乏情况。他们的实际年龄分别为11.4±0.4岁（平均±标准误）、14.0±0.7岁和12.8±0.8岁；身高年龄分别为11.0±0.4岁、8.9±0.7岁和6.3±0.4岁；骨龄分别为10.7±0.7岁、9.9±0.8岁和7.5±0.7岁。与其他试验相比，在“正常”受试者（对照组加身材矮小者）中，连续运动和左旋多巴试验诱导的血浆hGH峰值和综合分泌率最高（分别为16.5±1.2 ng/ml和679±70 ng/ml/120分钟）。这种联合刺激是所有“正常”受试者都有反应的唯一一种刺激：此前尚未描述过其他hGH刺激有类似程度的反应性。与“正常”受试者相比，GHD组在所有刺激下观察到的反应均显著降低（P＜0.001）。连续运动和左旋多巴试验被强调为评估生长发育迟缓儿童的一种无害、敏感且简化的方法。
