儿童生长激素刺激测试可以预测对生长激素治疗的反应吗?
Keren Smuel Zilberberg1, Michal Yackobovitch-Gavan2, Ariel Tenenbaum3
1The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
概括
增长激素 (GH) 治疗有效地改善了生长激素缺乏症 (GHD) 或特异性矮身 (ISS) 的儿童的身高. GH刺激测试 (GHST) 的结果并没有显著影响治疗结果,这表明其诊断作用可能需要重新评估.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 增长障碍 发展障碍 发展障碍
- 激素治疗是一种激素治疗.
背景情况:
- 增长激素 (GH) 治疗用于生长激素缺乏 (GHD) 或异常矮身 (ISS) 的矮小儿童.
- GH刺激测试 (GHST) 是主要的诊断工具,但其准确性和临床实用性仍有争议.
- 在GHD和ISS之间存在着公认的重叠,这使得诊断和治疗决策变得复杂.
研究的目的:
- 评估GH刺激测试 (GHST) 在区分GHD和ISS的临床意义.
- 根据GHST结果,将被诊断患有GHD的儿童对GH治疗的反应与ISS进行比较.
- 评估GHST结果是否影响矮小儿童的治疗结果.
主要方法:
- 在三级儿科内分泌诊所进行的回顾性研究.
- 对被诊断患有GHD或ISS的儿童3年生长激素 (GH) 治疗反应的分析.
- 基于诊断和GHST结果的身高增长和胰岛素样生长因子-1 (IGF-1) 水平的比较.
主要成果:
- 在所有接受治疗的儿童中,身高显著改善,IGF-1水平增加,无论GHST结果,性别或青春期状态如何.
- 身高增长与治疗指示没有关联 (GHD与GHD对比. 在调整剂量时,ISS) 或GHST的峰值水平.
- 这项研究包括291名儿童:97名患有GHD,194名患有ISS.
结论:
- 根据GHST分类为GHD或ISS的儿童对GH治疗表现出类似的反应.
- 调查结果质疑GHST在矮小儿童的诊断和管理中的关键作用.
- 需要重新考虑GHST的诊断和治疗影响.
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