Blatt J, Bercu B B, Gillin J C, Mendelson W B, Poplack D G
J Pediatr. 1984 Feb;104(2):182-6. doi: 10.1016/s0022-3476(84)80989-0.
Basal growth hormone levels were measured every 20 minutes over 24 hours in eight long-term survivors of acute lymphoblastic leukemia and in 13 age- and pubertal stage-matched normal children. Among the patients, the median total basal growth hormone output (AUC) was 43 units, compared with 341 units in the normal control group (P less than 0.001). In the patients, mean pulse amplitude (6.9 ng/ml) and frequency (4.6) over 24 hours also were reduced, compared with the control values (32 ng/ml and 8.5, P less than 0.001 and P less than 0.05, respectively). In addition, normal children secreted more GH at night (median AUC 280) than during the day (113, P less than 0.001). However, this diurnal pattern was absent in three of the patients studied. These data suggest that perturbations of spontaneous pulsatile GH secretion are common after standard therapy for ALL and may be a sensitive means of detecting therapy-related neuroendocrine damage. Blunting of spontaneous pulsatile GH secretion may contribute to the abnormalities in growth seen in children with ALL.
对8名急性淋巴细胞白血病长期幸存者和13名年龄及青春期阶段匹配的正常儿童，在24小时内每隔20分钟测量一次基础生长激素水平。在这些患者中，基础生长激素总输出量（AUC）的中位数为43单位，而正常对照组为341单位（P<0.001）。与对照组值（分别为32 ng/ml和8.5，P<0.001和P<0.05）相比，患者24小时内的平均脉冲幅度（6.9 ng/ml）和频率（4.6）也降低。此外，正常儿童夜间分泌的生长激素（AUC中位数280）比白天（113，P<0.001）更多。然而，在研究的3名患者中不存在这种昼夜模式。这些数据表明，在急性淋巴细胞白血病的标准治疗后，自发性脉冲式生长激素分泌紊乱很常见，可能是检测治疗相关神经内分泌损伤的一种敏感方法。自发性脉冲式生长激素分泌减弱可能导致急性淋巴细胞白血病患儿生长异常。
