Farthing M J, Campbell C A, Walker-Smith J, Edwards C R, Rees L H, Dawson A M
Gut. 1981 Nov;22(11):933-8. doi: 10.1136/gut.22.11.933.
Although impaired growth hormone secretion in response to pharmacological stimuli occurs in some growth retarded children with Crohn's disease, its relationship to past and future th is uncertain. We have therefore determined the growth hormone and gonadotrophin response to the physiological stimulus of sleep by continuous venous sampling in five severely gonadotrophin profiles, the mean plasma hormone concentrations during the first five hours of sleep were determined. In three of the five patients, five hour mean growth hormone levels were reduced (3.8, 5.0, and 8.5 mU/l) compared with levels reported previously in normal short children (10-43 mU/l), although the pulsatile pattern of growth hormone secretion was preserved in all. Nocturnal growth hormone secretion was unrelated to the growth velocities of these children during both pre- and post-treatment assessment periods but a significant correlation was found between growth hormone concentration and a disease activity score (r = 0.79, P less than 0.05), suggesting that growth hormone release by the pituitary was influenced by the severity of the disease. Nocturnal growth hormone secretion was also correlated with gonadotrophin secretion (luteinising hormones, r = 0.99, and follicle stimulating hormone, r = 0.96; p less than 0.01) indicating more extensive hypothalamic-pituitary disturbance. These findings suggest that hypothalamic-pituitary function is depressed in growth retarded children with Crohn's disease, but that abnormalities of growth hormone secretion are unlikely to be directly involved in the growth retardation seen in this condition.
尽管一些患有克罗恩病的生长迟缓儿童在受到药物刺激时生长激素分泌受损，但其与过去和未来生长的关系尚不确定。因此，我们通过对五名严重生长迟缓儿童进行连续静脉采样，测定了他们对睡眠这种生理刺激的生长激素和促性腺激素反应，并确定了睡眠前五个小时内的平均血浆激素浓度。在这五名患者中，有三名患者睡眠五小时的平均生长激素水平（分别为3.8、5.0和8.5 mU/l）低于先前报道的正常矮小儿童的水平（10 - 43 mU/l），尽管所有患者的生长激素分泌脉冲模式均得以保留。在治疗前和治疗后的评估期间，夜间生长激素分泌与这些儿童的生长速度均无关联，但发现生长激素浓度与疾病活动评分之间存在显著相关性（r = 0.79，P < 0.05），这表明垂体释放生长激素受疾病严重程度的影响。夜间生长激素分泌还与促性腺激素分泌相关（促黄体生成素，r = 0.99；卵泡刺激素，r = 0.96；P < 0.01），这表明下丘脑 - 垂体功能紊乱更为广泛。这些发现表明，患有克罗恩病的生长迟缓儿童下丘脑 - 垂体功能受到抑制，但生长激素分泌异常不太可能直接导致该疾病中的生长迟缓。
