矮小儿童生长激素检测的临床意义分析

目的评价矮小儿童血清中的生长激素（GH）水平,了解生长激素缺乏（GHD）与特发性矮小（ISS）患儿生长激素激发试验后GH峰值分布的差异及临床意义。方法采用化学发光法对80例矮小儿童进行生长激素联合激发试验（可乐定,精氨酸）,检测用药前及用药后30、60、90、120min时的血清GH水平。以测得的GH最高值为峰值,峰值≥10μg/L为GH不缺乏,10μg/L〉峰值≥5μg/L为GH部分缺乏;峰值〈5μg/L为完全缺乏。结果 80例患儿中,GHD占45.0%,其中部分GHD占31.25%;GHD与ISS患儿无性别差异（P〉0.05）。激发后GH峰值出现的时间以0～120分钟为主,占总数的81.25%,激发试验的GH峰值出现时间ISS患儿与GHD患儿无差异（P〉0.05）。结论矮小儿童中由GHD缺乏造成的矮小所占比例较高,且以部分缺乏为主,ISS也是引起矮小的主要原因。生长激素联合激发试验GHD和ISS患儿GH峰值出现的时间段无差异。

Clinical value of provocation test for growth horome in short stature children

Objective To assess the stimulation effect of arginine and clonidine on pituitary growth hormone secretion in growth hormone deficiency(GHD) and idiopathic short stature(ISS) children.Methods 80 cases of short stature children excluding other disease were screened with diagnosis standard.The subjects were underwent arginine and clonidine provocation test.Serum GH levels were determined with chemiluminescent,The highest GH value after provocation was termed as the peak value.The peak value was 10μg/L or above as provocation test positive(ISS).5μg/L or above as GH part deficiency,lower than 5ug/L as GH deficiency(GHD).Results The short stature children with GH peak value 10μg/L or above accounted 45%,including part GH deficiency was 31.25%.The peak value mostly focused on time 60-120 minutes accounted 81.25%,Time peak value was no different betweet GHD and ISS children.Conclusion GHD is the leading cause of acquired short stature in children.Time of peak value is no different arginine combined with clonidine provocation test.