| 周海群,王 丹,孙丽芃,王瑞芳,魏广友,刘 威.可乐定联合精氨酸激发试验在矮小儿童生长激素缺乏症中的诊断价值及生长激素峰值的影响因素分析[J].,2019,19(13):2555-2558 |
| 可乐定联合精氨酸激发试验在矮小儿童生长激素缺乏症中的诊断价值及生长激素峰值的影响因素分析 |
| Diagnostic Value of Clonidine Combined with Arginine Challenge Test in Growth Hormone Deficiency in Short Children and Analysis of Factors Affecting Growth Hormone Peak |
| 投稿时间：2019-01-04 修订日期：2019-01-27 |
| DOI：10.13241/j.cnki.pmb.2019.13.035 |
| 中文关键词: 矮小儿童 生长激素缺乏症 生长激素 影响因素 诊断价值 |
| 英文关键词: Short children Growth hormone deficiency Growth hormone Influencing factors Diagnostic value |
| 基金项目:安徽省科技攻关计划资助项目（15A0362211） |
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| 中文摘要: |
| 摘要 目的：探讨可乐定联合精氨酸激发试验在矮小儿童生长激素缺乏症（GHD）中的诊断价值，并分析生长激素（GH）峰值的影响因素。方法：选取2016年5月到2018年7月期间因身材矮小来安徽理工大学附属亳州医院就诊的矮小儿童120例，所有儿童均进行可乐定、精氨酸激发试验，比较可乐定、精氨酸、可乐定联合精氨酸激发试验的阳性率，以可乐定联合精氨酸激发试验的结果为标准，将120例矮小儿童分为GHD组（76例）和非GHD组（44例），比较两组儿童的年龄、骨龄、体质量指数（BMI）、体重指数标准差积分（BMI SDS）、胰岛素样生长因子-1（IGF-1）、胰岛素样生长因子结合蛋白-3（IGFBP-3）、GH峰值，分析可乐定联合精氨酸激发试验中GH峰值与各临床指标的相关性，并采用多因素逐步回归分析法分析可乐定联合精氨酸激发试验中GH峰值的影响因素。结果：可乐定联合精氨酸激发试验的阳性率高于可乐定激发试验和精氨酸激发试验的阳性率（P<0.05），可乐定激发试验的阳性率高于精氨酸激发试验的阳性率（P<0.05）。GHD组儿童BMI、BMI SDS高于非GHD组，IGF-1、GH峰值低于非GHD组（P<0.05）。经Pearson相关分析显示，可乐定联合精氨酸激发试验中儿童的BMI、BMI SDS与GH峰值呈负相关，IGF-1与GH峰值呈正相关（P<0.05）。多因素逐步回归分析结果显示，可乐定联合精氨酸激发试验中儿童的BMI SDS和IGF-1是GH峰值的影响因素（P<0.05）。结论：可乐定联合精氨酸激发试验在矮小儿童GHD诊断中具有较高的阳性率，其诊断价值高于两种药物单独进行激发试验，且儿童的BMI SDS和IGF-1是激发试验GH峰值的影响因素，在进行激发试验时需考虑儿童的BMI SDS和IGF-1水平对诊断结果造成的影响。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the diagnostic value of clonidine combined with arginine challenge test in growth hormone deficiency (GHD) in short children, and to analyze the influencing factors of growth hormone (GH) peak. Methods: 120 short children who came to Bozhou Hospital Affiliated to Anhui University of Technology from May 2016 to July 2018 were selected. All children were tested for clonidine and arginine challenge. The positive rates of clonidine, arginine, clonidine combined with arginine challenge test were compared. Based on the results of clonidine combined with arginine challenge test, 120 short children were divided into GHD group (76 cases) and non-GHD group (44 cases). The age, bone age, body mass index (BMI) and body mass index standard deviation scores (BMI SDS), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3) and GH peak value of the two groups were compared. The correlation between GH peak and clinical parameters in clonidine combined with arginine challenge test were analyzed. Multivariate stepwise regression analysis was used to analyze the influencing factors of GH peak in clonidine combined with arginine challenge test. Results: The positive rate of clonidine combined with arginine challenge test was higher than that of clonidine challenge test and arginine challenge test (P<0.05). The positive rate of clonidine challenge test was higher than that of arginine challenge test (P<0.05). The BMI and BMI SDS in GHD group were higher than those in non-GHD group. The peak values of IGF-1 and GH in GHD group were lower than those in non-GHD group (P<0.05). Pearson correlation analysis showed that BMI and BMI SDS of children in clonidine combined with arginine challenge test were negatively correlated with GH peak value, and IGF-1 was positively correlated with GH peak (P<0.05). Multivariate stepwise regression analysis showed that BMI SDS and IGF-1 of children in clonidine combined with arginine challenge test were the influencing factors of GH peak (P<0.05). Conclusion: The clonidine combined with arginine challenge test has a higher positive rate in short children with GHD. Its diagnostic value is higher than that of challenge test with two drugs alone. BMI SDS and IGF-1 were the influencing factors of GH peak in challenge test. The influence of BMI SDS and IGF-1 levels on the diagnosis results should be considered in challenge test. |
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