摘要
目的探讨原发性和继发性垂体前叶功能减退症患者胰岛素低血糖兴奋生长激素(growth hormone,GH)试验中低血糖事件差异,为临床试验中早期发现并治疗低血糖提供依据。方法回顾性分析2014年6月-2015年6月本院内分泌科收治的垂体前叶功能减退症患者63例,依据发病机制分为原发组(47例)和继发组(16例),分析试验中胰岛素应用剂量、发生低血糖时间、血糖值和不同时段监测GH和皮质醇分泌量等数据。结果两组患者均未发生严重低血糖反应和并发症;两组基本资料差异无统计学意义(P>0.05);原发组和继发组试验中胰岛素剂量[(8.3±4.02)U vs(5.6±2.9)U,P=0.01]、低血糖时间[(22.1±4.8)min vs(25.3±4.5)min,P=0.027]和血糖值[(2.42±0.48)mmol/L vs(2.04±0.59)mmol/L,P=0.032]差异均有统计学意义;原发组和继发组0 min、30 min、60 min、90 min时GH分泌量差异均有统计学意义(P=0.000)[(1.333±2.558)μg/L vs(0.059±0.024)μg/L;(1.885±3.392)μg/L vs(0.061±0.027)μg/L;(3.08±4.155)μg/L vs(0.056±0.017)μg/L;(1.856±2.94)μg/L vs(0.071±0.042)μg/L];原发组和继发组30 min、60 min、90 min时皮质醇分泌量差异均有统计学意义(P<0.05)[(255.170±109.087)nmol/L vs(172.013±153.861)nmol/L;(405.780±184.832)nmol/L vs(171.912±154.548)nmol/L;(330.092±147.754)nmol/L vs(128.400±114.567)nmol/L]。结论相对原发性病变,继发性病变患者更易发生严重低血糖反应,垂体功能较差,可能加重低血糖病程。
Objective To investigate the difference of hypoglycemia in insulin-induced hypoglycemic stimulating GH secretion test between patients with primary and secondary hypopituitarism in order to cure hypoglycemia early. Methods A retrospective study was performed on sixty-three patients with hypopituitarism from June 2014 to June 2015. According to the pathogenesis, patients were divided into primary group（n=47） and secondary group（n=16）. The basic data of patients, insulin dosage, hypoglycemic time, hypoglycemic value, production of GH and compound F were recorded. Results No severe hypoglycemia and adverse effect was found in two groups. The basic data in two groups had no（P 〉0.05）. The insulin dosage [（8.3±4.02） U vs（5.6±2.9） U, P=0.01], hypoglycemic time [（22.1±4.8） min vs（25.3±4.5） min, P=0.027] and hypoglycemic value [（2.42±0.48） mmol/L vs（2.04±0.59） mmol/L, P=0.032] in two groups had statistically significant difference. The production of GH at 0, 30, 60, 90 min in two groups had statistically significant difference [（1.333±2.558）μg/L vs（0.059±0.024）μg/L;（1.885±3.392）μg/L vs（0.061±0.027）μg/L;（3.08±4.155）μg/L vs（0.056±0.017）μg/L;（1.856±2.94）μg/L vs（0.071±0.042）μg/L, P=0.000]. The production of compound F at 30, 60, 90 min in two groups had statistically significant difference [（255.170±109.087） nmol/L vs（172.013±153.861） nmol/L;（405.780±184.832） nmol/L vs（171.912±154.548） nmol/L;（330.092±147.754） nmol/L vs（128.400±114.567） nmol/L, P 〈0.05]. Conclusion Compared with primary hypopituitarism, the secondary hypopituitarism is prone to develop severe hypoglycemia, with prolonged hypoglycemic time and worse pituitary function.
出处
《解放军医学院学报》
CAS
2016年第4期364-367,共4页
Academic Journal of Chinese PLA Medical School
关键词
垂体前叶功能减退症
低血糖兴奋生长激素试验
低血糖
垂体功能
hypopituitarism
insulin-induced hypoglycemic stimulating growth hormone secretion test
hypoglycemia
pituitary function
