原发性和继发性垂体前叶功能减退症患者低血糖兴奋生长激素试验中低血糖事件的差异分析

Difference of hypoglycemia in insulin-induced hypoglycemic stimulating GH secretion test between patients with primary and secondary hypopituitarism

  • 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。

     

    Abstract: Objective To investigate thedifference 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 weredivided into primary group (n=47) and secondary group (n=16). The basicdata of patients, insulindosage, 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 basicdata in two groups had no (P> 0.05). The insulindosage (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 significantdifference. The production of GH at 0, 30, 60, 90 min in two groups had statistically significantdifference (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 significantdifference (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 todevelop severe hypoglycemia, with prolonged hypoglycemic time and worse pituitary function.

     

/

返回文章
返回