儿童糖尿病垂体和甲状腺功能的研究

Study of Pituitary and Thyroid Function in Children with Type I Diabetes Mellitus

对控制良好的Ⅰ型糖尿病病人做生长激素激发试验及甲状腺激素水平的测定，以了解其垂体、甲状腺的功能状态。观察组与对照组各２０例，分别做上述试验和检测。生长激素激发试验中，服药及运动后两组有明显差异（Ｐ＜０．０５，Ｐ＜０．０１），血清Ｔ_４、ＴＳＨ水平也有明显差异（Ｐ＜０．０５，Ｐ＜０．０１），提示垂体与甲状腺功能与正常小儿不同。由于胰岛素有增加生长激素受体（ＣＨＲ）的基因转录和表达作用，从而增加后者的生理效应。因此对Ⅰ型糖尿病小儿合理使用胰岛素是治疗的关键，应定期检测甲状腺和垂体的功能，而ＧＨ激发试验是了解垂体功能的必要手段。

In order to understand the functional condition of pituitary and thyroid gland, the induced growth hormone (GH) test and serum thyroid hormones tested in 20 well-controlled patients with type-l diabetes mellitus (DM). Another 20 healthy children was tested as controls. In the induced GH test, the contents of tetraiodothyronine (T4) and thyroid stimulation hormone (TSH) in serum had marked differences between this two groups before and after taking medicine or exercise(P < 0. 05, P< 0. 01 ). The results suggested that the function of pituitary and thyroid gland in healthy children WAS different from that in children with type-1 DM. Insulin increased the gene transcription and gene expression in growth hormone receptor (GHR) and its physiological effect. The gene expression of GHR was in the thyroid gland tissue. Therefore, it is key treatment for children with type-l DM to give insulin in right dosage. The patients should be tested for the function of thyroid gland and pituitary. The induced GH test is the necessary method to understand the function of pipuitary.