在身高矮的患者中诊断垂体缺血的陷
Seniha Kiremitci Yilmaz1, Gülgün Yilmaz Ovali2, Deniz Ozalp Kizilay3
1Division of Pediatric Endocrinology, Health Sciences University, Istanbul Haseki Training and Research Hospital, Istanbul, Turkey. skyilmaz.dr@gmail.com.
Endocrine
|July 5, 2024
概括
骨年龄 (BA) 评估对于诊断患有生长问题儿童的垂体缺血症至关重要. 这种方法可以准确地区分生长激素缺乏症 (GHD) 和特异性矮身 (ISS),提高诊断精度.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 增长激素缺乏症 增长激素缺乏症
- 诊断成像 诊断成像 诊断成像
背景情况:
- 高度年龄 (HA) 和骨年龄 (BA) 的延迟在矮人中很常见,这可能会导致按时间年龄 (CA) 评估时过度诊断垂体缺血症.
- 精确诊断垂体缺血是必要的适当管理生长障碍.
研究的目的:
- 在患有生长激素缺乏症 (GHD) 的患者中,根据CA,HA或BA评估垂体高度 (PH) 和垂体体积 (PV) 的诊断和预后值.
- 确定最准确的方法来诊断小儿患者的垂体缺血症.
主要方法:
- 该研究包括57名严重GHD患者,40名部分GHD患者和39名异常矮人患者 (ISS).
- 脑下垂体高度 (PH) 和脑下垂体体积 (PV) 用时间年龄 (CA),骨年龄 (BA) 和身高年龄 (HA) 来评估.
- 分析了这些成像方法与临床特征之间的相关性.
主要成果:
- 与GHD患者相比,ISS患者的垂体体积 (PV) 显著增加.
- PV与高度SDS,GH,IGF-1,IGFBP-3和高度速度等临床参数的相关性更强.
- 基于骨年龄的PV显示出高诊断准确度,可以将GHD与ISS区分开来 (灵敏度:17%,特异性:98%,PPV:94%).
- 根据PV-BA.在3%的ISS和17%的GHD患者中发现了垂体缺血症.
结论:
- 按骨年龄 (BA) 评估的垂体体积 (PV) 为垂体缺血形成提供了最准确的诊断值.
- 虽然基于BA的PV可以提高诊断准确性,但潜在的误诊仍然是一个考虑因素.
- PV也是对复合生长激素 (rGH) 治疗反应的重要预测因子.
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