矮小症患儿胰岛素生长激素激发试验血糖检测的临床价值

Correlative study of blood glucose detection by the application of insulin in growth hormone stimulation test in children with short stature

目的探讨矮小症患儿胰岛素生长激素激发试验血糖检测频次,促进激发试验准确、顺利完成。方法322例矮小症患儿,行胰岛素生长激素激发试验,于注射胰岛素前及30 min、60 min、90 min、120 min采血标本检测生长激素,(测末梢血糖0 min、10 min、15 min、20 min、30 min、60 min、90 min、120 min),末梢血糖低于2.8 mmol/l,或基础值一半时,为有效血糖值。比较8次末梢血糖(测末梢血糖0 min、10 min、15 min、20 min、30 min、60 min、90 min、120 min)与5次末梢血糖(测末梢血糖0 min、30 min、60 min、90 min、120 min)达有效血糖值有效性。结果179例末梢血糖15 min内达有效血糖值,其中27例30 min时升至有效血糖值以上;136例末梢血糖15 min-30 min之间达有效血糖值,其中19例30 min时升至有效血糖值以上;17例末梢血糖未达有效血糖值。8次末梢血糖达有效血糖值占94.72%(305/322),5次末梢血糖达有效血糖值占80.4%(259/322),两者比较差异有统计学意义(P<0.01)。结论胰岛素生长激素激发试验是诊断矮小症的重要部分,是诊断生长激素缺乏症的确诊条件,达到有效血糖值是试验成功的必需条件,常规检测0 min、30 min、60 min、90 min、120 min末梢血糖,可导致有效血糖值的错失,可加强检测末梢血糖的频次,提高试验准确性,避免部分试验的失败,减少经济损失。

Objective To investigate the frequency of blood glucose detection by the application of insulin in growth hormone stimulation test in children with short stature to promote the accurate and successful completion of the stimulation test.Methods In 322 children with short stature,using the insulin in growth hormone stimulation test was performed.Before insulin injection and 30 min,60min,90min,and 120min,blood samples were collected to the detection of growth hormone(peripheral blood glucose was measured at 0 min、10 min、15 min、20 min、30 min、60 min、90 min、120 min),the peripheral blood glucoses reach the effective value,that is,when it was lower than 2.8 mmol/l,or half of the basic value.Compared the effectiveness of the peripheral blood glucose of 8 times(measuring peripheral blood glucose 0min、10min、15min、20min、30min、60min、90min、120min)with that of 5 times of peripheral blood glucose(measuring peripheral blood glucose 0 min、30 min、60 min、90 min、120 min)to reach the effective blood glucose value.Results 179 cases of peripheral blood glucose reached the effective glucose value within 15 minutes,of which 27 cases exceeded the effective glucose value at 30 minutes;136 cases reached the effective glucose value between 15-30 minutes,of which 19 cases exceeded the effective glucose value at 30 minutes;the effective glucose value was not reached in 17 cases of peripheral blood glucose.8 times of peripheral blood glucose reaching the effective value of blood glucose accounted for 94.72%(305/322),and 5 times of peripheral blood glucose reaching the effective value of blood glucose accounted for 80.4%(259/322),which was a statistically significant difference(P<0.01).Conclusion Using Insulin in growth hormone stimulation test was an important part of the diagnosis of short stature,and it was the diagnosis condition for diagnosing short stature caused by growth hormone deficiency.Reaching the effective value of blood glucose was a necessary condition for the success of the test,Routine detection of peripheral blood glucose at 0 min、30 min、60 min、90 min、120 min might lead to the loss of effective value of blood glucose,and could strengthen the frequency of detection of peripheral blood glucose,the accuracy of the test would be improved,the failure of some tests would be avoided,and the economy loss would be reduced.