LESSON OF THE WEEK - HAZARDS OF PHARMACOLOGICAL TESTS OF GROWTH-HORMONE SECRETION IN CHILDHOOD
LESSON OF THE WEEK - HAZARDS OF PHARMACOLOGICAL TESTS OF GROWTH-HORMONE SECRETION IN CHILDHOOD
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DOI：
10.1136/bmj.304.6820.173
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发表时间：
1992-01-18
影响因子：
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通讯作者：
MATTHEW, D
中科院分区：
文献类型：
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作者：
SHAH, A;STANHOPE, R;MATTHEW, D
生长激素缺乏的儿童现在可以用生物合成的人类生长激素治疗。在开始治疗前，应检查患儿的垂体功能。这通常是通过生长激素分泌的药理学测试来完成的，最常见的测试是胰岛素诱导的低血糖。然而，这些测试的结果可能难以解释，特别是在肥胖和青春期前晚期反应迟钝、饥饿时生长激素浓度高、乳糜泻和心理矮化症时生长激素不足的儿童中。生长激素自发的生理分泌的测试结果可以解释药理学测试获得的许多错误印象，尽管总的来说，它们在选择将受益于合成生长激素的儿童方面可能没有优势。药理学试验的另一个问题是低血糖管理不当可能导致严重的并发症。我们报告两名儿童死亡，一名儿童在生长激素分泌测试后出现神经损伤。这三个人在过去三年里都住过我们医院。
Children with growth hormone deficiency can now be treated with biosynthetic human growth hormone. Before treatment is started the pituitary function of the child should be investigated. This is usually done with a pharmacological test of growth hormone secretion,'the commonest test being insulin induced hypoglycaemia. The results of these tests may, however, be difficult to interpret, I especially in children with blunted responses in obesity and late prepuberty, high growth hormone concentrations in starvation, and growth hormone insufficiency in coeliac disease and psychosocial dwarfism. Results of tests of spontaneous, physiological secretion of growth hormone may explain many false impressions gained by pharmacological tests,'although overall they may have no advantage in selecting children who would benefit from synthetic growth hormone. 4 Another problem with pharmacological tests is that mismanagement of hypoglycaemia may cause serious complications. We report on two children who died and one who developed neurological damage after tests of growth hormone secretion. All three were admitted to our hospital during the past three years.