用联合下丘脑释放激素兴奋试验评价特发性生长激素缺乏性侏儒其他垂体前叶激素的储备功能

EVALUATION OF ANTERIOR PITUITARY FUNCTION BY COMBINED ADMINISTRATION OF HYPOTHALAMIC RELEASING HORMONE IN PATIENTS WITH IDIOPATHIC GROWTH HORMONE DEFICIENCY

联合使用GHRH、TRH、LHRH和CRH四种下丘脑释放激素检查6例正常青少年和50例未治疗IGHD患者血PRL、TSH、LH及F的反应,并从基础值、峰值、峰值增加值、峰值/基础值比值、激素反应曲线下面积和阳性反应率等六个方面比较两组结果。IGHD患者血PRL、TSH及F六项指标的反应与对照组比较差异无显著性,表明IGHD患者垂体PRL、TSH及ACTH细胞的储备功能正常。约2/3IGHD患者LH细胞的储备功能低下。在青春发育年龄的IGHD患者LH对LHRH的反应除峰值/基础值比值以外,另五项指标均非常明显低于对照组(P<0.001),这可能是成年IGHD患者性发育延迟及差的原因。

The functional reserve of pituitary PRL, TSH, LH and ACTH cells were investigated in 6 control subjects and 50 untreated IGHD patients by combined administration of TRH, GHRH, LHRH and CRH. The response of serum PRL, TSH, LH and F were expressed in terms of basal level, peak level, peak level increase, ratio of peak and basal level, area under hormone response curve and percentage of positive response. The response of all the six indices of PRL, TSH and F in IGHD group were not significantly different from that in control group (P>0.05), indicating that the functional reserve of PRL, TSH and ACTH cells were normal in IGHD patients. Except the ratio of peak and basal level, all the other five indices of the LH response to LHRH were significantly lower in IGHD patients than in normals of puberty. The functional reserve of LH cell was low in about 2/3 IGHD patients. These results might explain the delayed or no puberty in adult IGHD patients.