胰岛素激发试验在成人鞍区病变的应用及安全性观察

Clinical observation of application and safety of insulin tolerance test in sellar lesions

目的探讨胰岛素激发试验(ITT)在成人鞍区病变的应用价值和安全性。方法选择2012-01—2013-06连续收治的鞍区病变患者60例,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 60例受试者均完成试验,激发试验结果38例(63.3%)为阴性,不同鞍区病变ITT试验的峰值不同以颅咽管瘤峰值最低,脑膜瘤最高(F=3.094,P=0.000)。结论 ITT试验能可反应不同鞍区病变的下丘脑-垂体生长激素轴及皮质激素轴功能,测定的GH峰值与IGF-1、BMI相关;在严格选择对象、密切监护情况下,ITT试验用于成人鞍区病变患者安全可靠,有极高的诊断价值。

Objective To evaluate the practical value and safety of the insulin tolerance test （ITT） in patients with sellar lesions. Methods A total of 60 patients with sellar lesions admitted from July 2012 to June 2013 were involved in this study. 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 60 subjects completed the trial,based on the provocation test,the result of 38 cases （63.3 %） was negative. Peak GH responses were different between the groups（F= 3. 094,P =0. 000）. The lowest peak GH was in craniopharyngioma group and the highest peak GH was in meningioma. Conclusion ITT test can reflect the different the hypothalamic-pituitary growth hormone and corticosteroids axis function of sellar lesions. There was a highly significant correlation between peak GH values and IGF-1 ,BMI value. When ITT is carried out in carefully selected patients with sellar lesions,it is a safe and reliable clinical diagnostic test.