胰岛素生长激素激发试验与可乐定生长激素激发试验在矮小症儿童中的应用比较

Comparison of the application of insulin growth hormone provocation test and clonidine growth hormone provocation test in children with short stature

目的比较胰岛素生长激素(GH)激发试验与可乐定GH激发试验的临床效果。方法回顾性分析2018年10月至2020年10月在该院儿科住院诊断为矮小症的111例患儿的临床资料,分析胰岛素GH激发试验与可乐定GH激发试验的GH峰值、达峰时间及不良反应。结果胰岛素GH激发试验的GH峰值为(6.29±4.52)ng/mL,可乐定GH激发试验的GH峰值为(7.45±4.44)ng/mL,差异无统计学意义(P>0.05)。胰岛素GH激发试验中74.77%(83/111)的患儿在30 min GH分泌达到峰值,60 min所有患儿GH分泌均达到峰值;可乐定GH激发试验有峰值延后现象,有2.70%(3/111)的患儿在30 min GH分泌达到峰值,75.68%(84/111)的患儿在60 min GH分泌达到峰值,16.22%(18/111)的患儿在90 min GH分泌达到峰值,5.40%(6/111)的患儿在120 min GH分泌达到峰值。胰岛素GH激发试验不良反应的发生率为10.81%,可乐定GH激发试验不良反应的发生率18.92%,差异无统计学意义(P=0.90)。结论胰岛素、可乐定GH激发试验激发效果及不良反应发生率无明显差异,胰岛素GH激发试验60 min内达峰率较可乐定GH激发试验高。

Objective To compare the clinical effects of insulin growth hormone(GH)provocation test and clonidine GH provocation test.Methods The clinical data of 111 children with short stature diagnosed in our hospital from October 2018 to October 2020 were retrospectively analyzed.The GH peak,peak time and adverse reactions of insulin GH provocation test and clonidine GH provocation test were analyzed.Results The peak GH of insulin GH challenge test was(6.29±4.52)ng/mL,and the GH peak of clonidine GH challenge test was(7.45±4.44)ng/mL,the difference was not statistically significant(P>0.05).In the insulin GH challenge test,74.77%(83/111)of the children reached the peak GH secretion at 30 min,and all the GH secretions reached the peak at 60 min.The clonidine GH challenge test had a peak delay phenomenon,2.70%(3/111)of the children reached the peak GH secretion at 30 min,and 75.68%(84/111)of the children reached the peak GH secretion at 60 min,16.22%(18/111)of the children reached the peak of GH secretion at 90 min,and 5.41%(6/111)of the children reached the peak of GH secretion at 120 min.The incidence of adverse reactions in the insulin GH provocation test was 10.81%,and the incidence of adverse reactions in the clonidine GH provocation test was 18.92%.The difference was not statistically significant(P=0.90).Conclusion There is no significant difference of GH peak value between hypoglycemia stimulation test and clonidine provocative test,but the time to reach the peak was much shorter in the insulin-induced GH-releasing test.