5473例促生长激素刺激药理试验的统计研究(n=9)。建议的权重系数]。

Annales de pediatrie Pub Date : 1993-09-01
P Rochiccioli, C Enjaume, M T Tauber, C Pienkowski, I Oliver
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引用次数: 0

摘要

在3143名儿童中共进行了5473次药理学刺激生长激素释放试验。平均年龄9岁9个月(范围3-16岁),平均骨龄7岁6个月(范围2-14岁)。试验分为9种不同类型:1)精氨酸(n = 625);2)可乐定(n = 339);胰岛素(n = 198);4)鸟氨酸(n = 162);5)胰岛素+精氨酸(203例);6)可乐定+倍他洛尔(n = 2003);7)左旋多巴(n = 685);8)胰高血糖素=心得安(n = 443);9)胰高血糖素+倍他洛尔(n = 815)。所有生长激素的测定均采用相同的放射免疫测定法。每次试验所得值的分布呈高斯对数分布。95%置信限的平均峰值水平如下:1)10.2和0.45;2) 11.5和0.7;3) 11.8和0.8;4) 14.2和1.2;5) 14.3和0.9;6) 15.7和1.1;7) 19.8和2.1;8) 20.8和2.3;9) 21.0和2.5。这些数据表明特异性较低,从一种检测到另一种检测的平均峰值水平差异高达两倍;10 ng/ml以下峰的比例为29% ~ 69%。因此,诊断为生长激素缺乏症的患者的比率可能根据所使用的测试有很大的不同。为了减少这些差异,我们建议使用1)1.9的权重系数来调整测试结果;2) 1.48;3) 1.4;4) 1.16;5) 1.06;6) 1.01;7) 0.73;8) 0.69;9) 0.66。
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[Statistic study of 5,473 somatotropin secretion stimulation pharmacologic tests (n=9). Proposed weighting coefficient].

A total of 5,473 pharmacological provocative growth hormone release tests were carried out in 3,143 children. Mean age was 9 years 9 months (range 3-16 years) and mean bone age was 7 years 6 months (range 2-14 years). Tests were of 9 different types: 1) arginine (n = 625); 2) clonidine (n = 339); 3) insulin (n = 198); 4) ornithine (n = 162); 5) insulin + arginine (n = 203); 6) clonidine + betaxolol (n = 2,003); 7) L-dopa (n = 685); 8) glucagon = propranolol (n = 443); 9) glucagon + betaxolol (n = 815). All growth hormone determinations were performed using the same radioimmunoassay. Distribution of values obtained with each test was gausso-logarithmic. Mean peak levels with their 95% confidence limit were as follows: 1) 10.2 and 0.45; 2) 11.5 and 0.7; 3) 11.8 and 0.8; 4) 14.2 and 1.2; 5) 14.3 and 0.9; 6) 15.7 and 1.1; 7) 19.8 and 2.1; 8) 20.8 and 2.3; 9) 21.0 and 2.5. These data indicate low specificity, with up to two-fold differences in mean peak levels from one test to another; proportions of peaks under 10 ng/ml ranged from 29% to 69%. Thus, the rate of patients diagnosed with growth hormone deficiency may vary substantially according to the test used. To reduce these discrepancies, we suggest adjustment of test results using a weighting coefficient of 1) 1.9; 2) 1.48; 3) 1.4; 4) 1.16; 5) 1.06; 6) 1.01; 7) 0.73; 8) 0.69; 9) 0.66.

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