左旋多巴激发试验对儿童生长激素缺乏症的临床价值

Clinical Value of L-dopa Provocation Test in Children with Growth Hormone Dificiency

目的:探讨左旋多巴激发试验在诊断儿童生长激素缺乏症(GHD)的临床价值。方法:对330例身材矮小儿童应用左旋多巴激发试验,采用化学发光法进行生长激素(GH)检测。以测得的GH最高值为峰值,峰值≥10ng/ml为GH不缺乏,激发试验阳性;10ng/ml>峰值≥5ng/ml为GH部分缺乏,峰值<5ng/ml为GH缺乏,激发试验阴性。结果:激发后峰值强度为(12.23±8.10)ng/ml;峰值出现在(30～90)min者占96%,出现在120min者占4%(阳性3例),两者峰值有显著性差异(P<0.01);GH完全缺乏者占21%,部分缺乏者占22%,完全不缺乏者占57%。结论:左旋多巴激发试验可应用于临床GHD的诊断,但其诊断敏感度低,需要联合其它激发方式和其它指标对GHD患者进行综合评价。

Objective To investigate the clinical value of L-dopa provocation test on the diagnosis of growth hormone deficiency （GHD） children. Methods The L-dopa provocation tests were performed in 330 subjects with short stature. Serum GH level was de- termined by chemiluminescence immunoassay. The highest GH value after provocation was termed as the peak value, the peak value was 10ng/ml or above as provocation test positive （no GH difieiency ） ; 5ng/ml or above as part deficiency and lower than 5ng/ml as GH deficiency, provocation test negative. Results The peak value of serum GH after L-dopa provocation test was （ 12.23 ＋ 8.10） ng/ml;mosfly focused on period of 30 to 90 min （96%） ,only 4% were distributed at 120min after administration, the peak values were significant different between them（P 〈 0.01 ）. GH dificiency accouted for 21%, part dificiency accouted 22% individually, no GH dificiency aceouted 57%. Conclusion The L-dopa provocation test could be used in clinical diagnosis of GHD, but as the low diag- nostic sensitivity, it shoud be combined with other provocation tests or other indicators to comprehensive evaluated GHD.