左旋多巴激发试验对儿童生长激素缺乏症的临床价值

目的:探讨左旋多巴激发试验在诊断儿童生长激素缺乏症(GHD)的临床价值。方法:对330例身材矮小儿童应用左旋多巴激发试验,采用化学发光法进行生长激素(GH)检测。以测得的GH最高值为峰值,峰值≥10ng/ml为GH不缺乏,激发试验阳性;10ng/ml>峰值≥5ng/ml为GH部分缺乏,峰值<5ng/ml为GH缺乏,激发试验阴性。结果:激发后峰值强度为(12.23±8.10)ng/ml;峰值出现在(30～90)min者占96%,出现在120min者占4%(阳性3例),两者峰值有显著性差异(P<0.01);GH完全缺乏者占21%,部分缺乏者占22%,完全不缺乏者占57%。结论:左旋多巴激发试验可应用于临床GHD的诊断,但其诊断敏感度低,需要联合其它激发方式和其它指标对GHD患者进行综合评价。

Clinical Value of L-dopa Provocation Test in Children with Growth Hormone Dificiency

Objective To investigate the clinical value of L-dopa provocation test on the diagnosis of growth hormone deficiency(GHD) children.Methods The L-dopa provocation tests were performed in 330 subjects with short stature.Serum GH level was determined by chemiluminescence immunoassay.The highest GH value after provocation was termed as the peak value,the peak value was 10ng/ml or above as provocation test positive(no GH dificiency);5ng/ml or above as part deficiency and lower than 5ng/ml as GH deficiency,provocation test negative.Results The peak value of serum GH after L-dopa provocation test was(12.23±8.10)ng/ml;mostly focused on period of 30 to 90 min(96%),only 4% were distributed at 120min after administration,the peak values were significant different between them(P<0.01).GH dificiency accouted for 21%,part dificiency accouted 22% individually,no GH dificiency accouted 57%.Conclusion The L-dopa provocation test could be used in clinical diagnosis of GHD,but as the low diagnostic sensitivity,it shoud be combined with other provocation tests or other indicators to comprehensive evaluated GHD.