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5473例生长激素分泌刺激药理试验(n = 9)的统计研究。建议的加权系数

[Statistic study of 5,473 somatotropin secretion stimulation pharmacologic tests (n=9). Proposed weighting coefficient].

作者信息

Rochiccioli P, Enjaume C, Tauber M T, Pienkowski C, Oliver I

机构信息

Service de Pédiatrie, CHU Purpan, Toulouse.

出版信息

Ann Pediatr (Paris). 1993 Sep;40(7):391-5.

PMID:8239389
Abstract

A total of 5,473 pharmacological provocative growth hormone release tests were carried out in 3,143 children. Mean age was 9 years 9 months (range 3-16 years) and mean bone age was 7 years 6 months (range 2-14 years). Tests were of 9 different types: 1) arginine (n = 625); 2) clonidine (n = 339); 3) insulin (n = 198); 4) ornithine (n = 162); 5) insulin + arginine (n = 203); 6) clonidine + betaxolol (n = 2,003); 7) L-dopa (n = 685); 8) glucagon = propranolol (n = 443); 9) glucagon + betaxolol (n = 815). All growth hormone determinations were performed using the same radioimmunoassay. Distribution of values obtained with each test was gausso-logarithmic. Mean peak levels with their 95% confidence limit were as follows: 1) 10.2 and 0.45; 2) 11.5 and 0.7; 3) 11.8 and 0.8; 4) 14.2 and 1.2; 5) 14.3 and 0.9; 6) 15.7 and 1.1; 7) 19.8 and 2.1; 8) 20.8 and 2.3; 9) 21.0 and 2.5. These data indicate low specificity, with up to two-fold differences in mean peak levels from one test to another; proportions of peaks under 10 ng/ml ranged from 29% to 69%. Thus, the rate of patients diagnosed with growth hormone deficiency may vary substantially according to the test used. To reduce these discrepancies, we suggest adjustment of test results using a weighting coefficient of 1) 1.9; 2) 1.48; 3) 1.4; 4) 1.16; 5) 1.06; 6) 1.01; 7) 0.73; 8) 0.69; 9) 0.66.

摘要

对3143名儿童共进行了5473次药物激发生长激素释放试验。平均年龄为9岁9个月(范围3 - 16岁),平均骨龄为7岁6个月(范围2 - 14岁)。试验有9种不同类型:1)精氨酸(n = 625);2)可乐定(n = 339);3)胰岛素(n = 198);4)鸟氨酸(n = 162);5)胰岛素 + 精氨酸(n = 203);6)可乐定 + 倍他洛尔(n = 2003);7)左旋多巴(n = 685);8)胰高血糖素 = 普萘洛尔(n = 443);9)胰高血糖素 + 倍他洛尔(n = 815)。所有生长激素测定均使用相同的放射免疫测定法。每次试验获得的值的分布为高斯对数分布。平均峰值水平及其95%置信限如下:1)10.2和0.45;2)11.5和0.7;3)11.8和0.8;4)14.2和1.2;5)14.3和0.9;6)15.7和1.1;7)19.8和2.1;8)20.8和2.3;9)21.0和2.5。这些数据表明特异性较低,从一种试验到另一种试验平均峰值水平相差高达两倍;低于10 ng/ml的峰值比例在29%至69%之间。因此,根据所使用的试验,诊断为生长激素缺乏症的患者比例可能有很大差异。为减少这些差异,我们建议使用以下加权系数调整试验结果:1)1.9;2)1.48;3)1.4;4)1.16;5)1.06;6)1.01;7)0.73;8)0.69;9)0.66。

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