生长激素缺乏症的诊断和治疗

Diagnosis and treatment of growth hormone deficiency

生长激素缺乏症（GHD）在儿童主要以身材矮小、生长障碍为主要表现，成人患者表现多无特异性，可有身体组分改变、血脂紊乱、骨密度降低、运动耐力下降、胰岛素抵抗、心血管风险增加、生活质量下降等。临床一般需要结合病史、发育状况、症状、体征、影像学资料、生长激素（GH）-胰岛素样生长因子（IGF）轴相关生化指标及GH激发试验来作出诊断。治疗主要以GH替代促进矮小患儿的生长，改善成人患者代谢、身体组分、骨骼的异常改变及心血管危险因素等，提高生活质量。

The mainly manifestations in children with growth hormone deficiency（GHD） are short stature and growth failure. In adults,however,the signs and symptoms of GHD are less clear,such as alterations in body composition, unfavorable lipid profiles, reduced bone mineral density, impaired exercise perform- ance, insulin resistance, adverse cardiovascular risk factors, impairment of quality of life and so on. It requires comprehensive clinical and auxological assessment, combined with radiological evaluation and biochemical tests of the growth hormone（GH） -insulin-like growth factor （IGF） axis including GH provocative testing to make the proper diagnosis. GH replacement is a rational therapy for GHD to promote the line-growth in chil- dren, and to improve the abnormalities of metabolism, body composition, bone and cardiovascular risk factors, therefore to enhance the quality of life in adults.