生长激素刺激试验在生长发育迟缓的鉴别诊断中的临床意义

Clinical Significance of Growth Hormone Stimulation Test in Differential Diagnosis of Growth Retardation

目的探讨生长激素刺激试验在生长发育迟缓的鉴别诊断中的临床意义。方法选择2022年1月至2023年1月广丰区人民医院收治的生长发育迟缓患儿68例,按照随机数字表法将其分为对照组与观察组,对照组采用左旋多巴联合精氨酸行两日序贯生长激素(GH)激发试验,观察组采用左旋多巴联合精氨酸行单日复合GH激发试验,对比两组患儿GH峰值、GH阳性率、胰岛素样生长因子-1(IGF-1)与胰岛素样生长因子结合蛋白-3(IGFBP-3)水平。结果观察组激发试验前GH水平基础值、激发试验后GH水平峰值与对照组比较差异无统计学意义(P>0.05);观察组激发试验后GH分泌阳性率高于对照组,差异具有统计学意义(P<0.05);观察组激发试验后IGF-1与IGFBP-3水平与对照组比较差异无统计学意义(P>0.05);观察组激发试验后1年身高、体质量均显著提高,且观察组较对照组更高(P<0.05);两组不良反应比较差异无统计学意义(P>0.05)。结论生长激素刺激实验中,左旋多巴联合精氨酸行单日复合GH激发试验相较于左旋多巴联合精氨酸行两日序贯GH激发试验能更好地激发GH分泌,有更高的阳性率,能促进生长发育。

Objective To explore the clinical significance of growth hormone stimulation test in differential diagnosis of growth retardation.Methods 68 children with growth retardation admitted to Guangfeng District People's Hospital from January 2022 to January 2023 were selected and randomly divided into control group and observation group.The control group was given levodopa combined with arginine for two-day sequential growth hormone(GH)provocation test,and the observation group was given levodopa combined with arginine for one-day compound GH provocation test.The peak GH,GH positive rate,insulin-like growth factor-1(IGF-1)and insulin-like growth factor binding protein-3(IGFBP-3)levels of the two groups were compared.Results There was no significant difference in the basal value of GH level before provocation test and the peak value of GH level after provocation test between the observation group and the control group(P>0.05);the positive rate of GH secretion in the observation group after provocation test was higher than that in the control group,and the difference was statistically significant(P<0.05);there was no significant difference in IGF-1 and IGFBP-3 levels between the observation group and the control group after provocation test(P>0.05);the height and weight of the observation group were significantly increased 1 year after the challenge test,and the observation group was higher than the control group(P<0.05);there was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion In the growth hormone stimulation experiment,levodopa combined with arginine single day compound GH provocation test can better stimulate GH secretion than levodopa combined with arginine two-day sequential GH provocation test,with a higher positive rate.