ITT试验的诊断价值及安全性观察

Clinical observation of diagnostic value and safety of insulin tolerance test

目的探讨胰岛素低血糖-生长激素刺激试验(ITT)的应用价值和安全性。方法选择2009年7月-2011年3月连续收治的疑似生长激素缺乏症(GHD)患者67例,男27例,女40例,年龄7～64岁。所有患者均进行ITT试验,检测过程中观察受试者低血糖反应情况及血压、心率等生命体征的变化。结果 67例受试者均完成试验,无一例脱落或出现昏迷、惊厥等严重低血糖反应。激发试验结果53例(79.1%)为阴性,其中31例垂体瘤术后患者和席汉综合征患者通过该试验可确诊为GHD,22例身材矮小患者通过该试验有助于其诊断GHD。试验过程中部分受试者虽有生命体征的变化,但予以口服葡萄糖水后3～5min内均缓解。结论在严格选择对象、加强防范措施、密切监视血糖和生命体征的情况下,ITT试验用于临床安全可靠。

Objective To evaluate the practical value and safety of the insulin tolerance test（ITT）.Methods A total of 67 patients with suspected growth hormone deficiency（GHD） admitted from July 2009 to March 2011 were involved in this study.There were 27 male patients and 40 female patients,aged 7 to 64.All patients underwent the ITT test.The reaction to hypoglycemia,changes in blood pressure and heart rate,and other vital signs were observed in the process of clinical investigation.Results All the 67 subjects completed the trial,among them no one suffered from severe hypoglycemia,as manifested as coma,convulsions,and so on.Based on the provocation test,the result of 53 cases（79.1%） was negative.Among them,31 patients,including those who had undergone surgery of pituitary adenoma and those with Sheehan＇s syndrome,were diagnosed to suffer from GHD.This test was helpful in diagnosing 22 of patients with short stature as GHD.Although some subjects showed fluctuation of vital signs during the test,all of them were relieved within 3 min to 5 min with oral glucose solution.Conclusion When ITT is carried out in carefully selected patients under enhanced preventive measures and intensively monitored blood glucose level and vital signs,it is a safe and reliable clinical diagnostic test.