精氨酸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 arginine growth hormone stimulating test and clonidine growth hormone stimulating test in children with short stature

目的分析比较精氨酸与可乐定生长激素(GH)激发试验在儿童矮小症中的临床应用价值。方法回顾性分析温州市人民医院2018年6月至2021年6月住院诊断为矮小症的162例患儿的临床资料,给予精氨酸、可乐定激发试验,比较分析试验0 min、30 min、60 min、90 min生长激素值。结果162例患儿中,14例(8.64%)患儿表现为GH完全缺乏,58例(35.80%)患儿表现为GH部分缺乏。采用可乐定激发试验的阳性率为48.15%(78例),高于采用精氨酸激发试验的阳性率21.60%(35例),差异具有统计学意义(P<0.05)。联合采用精氨酸与可乐定激发试验的阳性率高达55.56%(90例)。可乐定激发试验的GH峰值为(10.35±4.96)μg/L,精氨酸激发试验的GH峰值为(7.26±5.85)μg/L,两者比较,差异无统计学意义(P>0.05)。可乐定峰值时间主要集中于60 min,达60.49%;精氨酸峰值时间分别集中于30 min,60 min,分别达到40.1%、32.1%。结论精氨酸联合可乐定激发试验可作为儿童GH缺乏的诊断性试验。可乐定激发试验的阳性率高于精氨酸试验结果,两种药物联合诊断的价值要优于单种药物。

Objective:To analyze and compare the clinical application value of arginine and clonidine growth hormone(GH)provocation test in children with short stature.Methods:The clinical data of 162 children diagnosed as short stature in Wenzhou People's Hospital from June 2018 to June 2021 were retrospectively analyzed.Arginine and clonidine provocation tests were given,and the growth hormone values of 0 min、30 min、60 min and 90 min were compared and analyzed.Results:Among 162 cases,14 cases(8.64%)showed complete GH deficiency,and 58 cases(35.80%)showed partial GH deficiency.The positive rate of clonidine provocation test was 48.15%(78 cases),which was higher than that of arginine provocation test(21.60%,35 cases),and the difference was statistically significant(P<0.05).The positive rate of arginine and clonidine provocation test was as high as 55.56%(90 cases).The peak GH of clonidine challenge test was(10.35±4.96)μg/L,and that of arginine challenge test was(7.26±5.85)μg/L.There was no significant difference between them(P>0.05).The peak time of clonidine mainly concentrated in 60 min,reaching 60.49%;The peak time of arginine was concentrated in 30 min and 60 min,reaching 40.1%and 32.1%respectively.Conclusion:Arginine combined with clonidine provocation test can be used as a diagnostic test for GH deficiency in children.The positive rate of clonidine provocation test is higher than that of arginine test,and the value of combined diagnosis of two drugs is better than that of single drug.