生长激素

生长激素（GH）由垂体分泌，是维持儿童正常生长发育和正常骨骼结构所必需的激素。儿童生长激素分泌不足会导致生长较同龄人缓慢，是生长素缺乏症（GHD）最早出现的症状之一。需要注意的是身材矮小可能与家族特征或其他遗传性疾病有关。过量生长激素分泌多为垂体瘤（通常为良性）所致。过多的生长激素可以导致儿童四肢长骨在青春期后继续生长，从而发展为巨人症，身高可超过210厘米。这些生长激素分泌过多患者也可能出现面部增长变阔，体力衰弱，青春期延迟和头痛等症状。

        尽管生长激素在成人中并不活跃，但在调节骨密度、肌肉质量和脂肪代谢中扮演重要角色。生长激素分泌不足会导致骨密度降低，肌肉重量减轻和异常脂质水平。成人生长激素分泌过多可导致肢端肥大症。虽然患者皮肤增厚、多汗、易疲劳、头痛和关节疼痛等症状在疾病初期并不显著，增高的生长激素水平会导致手足、面部骨骼增大，腕管综合症和内脏器官异常增大。如果未经治疗，肢端肥大症（儿童巨人症）会导致2型糖尿病、心血管疾病风险增高、高血压、关节炎等并发症，总的说来，即患者寿命缩短。

        生长激素刺激和抑制试验通常用于生长激素异常的诊断。因为生长激素由垂体脉冲式分泌，随机的生长激素水平测定无临床意义。

通常需进行生长激素抑制或刺激试验。患者空腹10-12小时后抽取肘部静脉血，然后在医生监护下，给予一定标准浓葡萄糖水（抑制试验）口服或静脉注射胰岛素/精氨酸（刺激试验）。随后在规定时间间隔抽取肘部静脉血。检测每次样本中生长激素水平用以监测一段时间内激素水平变化。

        有时，也可检测空腹或剧烈运动后单次血液样本中激素水平。

健康成人中生长激素维持微量水平，但在餐后3-4小时或入睡60分钟内急剧升高。因此检测前患者需空腹。

疾病: 脑垂体疾病, 甲状腺疾病

The Hormone Foundation
National Institute of Diabetes and Digestive and Kidney Diseases
The Magic Foundation

S1
Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

S2
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

S3
Sadovsky, R. (2002 August 6). Are We Ready for Growth Hormone Therapy in Adults? [5 paragraphs]. American Family Physician, Tips form other journals [On-line journal]. Available FTP: http://www.aafp.org/afp/20021115/tips/10.html

S4
Growth Hormone (Human Growth Hormone, HGH, Somatotropin) [5 paragraphs]. ARUP's Guide to Clinical Laboratory Testing (CLT) [On-line test information]. Available FTP: http://www.aruplab.com/guides/clt/tests/clt_a244.htm

S5
Growth Hormone Information [32 paragraphs]. The Hormone Foundation [On-line information]. Available FTP: http://www.hormone.org/learn/growth.html

S6
(2002 November 12, Updated). Growth hormone no fountain of youth, study suggests [17 paragraphs]. LaurusHealth.com, Today’s Headlines [Online information from Reuters Health]. Available FTP: http://www.laurushealth.com/healthnews/reuters//NewsStory111220023.htm

S7
Growth hormone tests [32 paragraphs]. Hendrick Health System, AccessMed [On-line information]. Available FTP: http://www.hendrickhealth.org/healthy/00049860.html

S8
Ruppe, M., Reviewed (2002 February 23, Reviewed). Growth hormone [9 paragraphs]. Pennhealth.com Health Illustrated Encyclopedia [On-line information]. Available FTP: http://www.pennhealth.com/ency/article/003706.htm

S9
Spengler, R. (2001 April 9, Updated). Growth Hormone [21 paragraphs]. LaurusHealth.com, Medical Tests [On-line information]. Available online

S10
AACE Clinical Practice Guidelines for Growth Hormone Use in Adults and Children. Available as PDF file: http://www.aace.com/clin/guidelines/hgh.pdf

S11
Bernal-Mizrachi, C., Updated (2001 June 2, Updated). Growth hormone stimulation test [18 paragraphs]. MEDLINEplus Health Information [On-line information]. Available FTP: http://www.nlm.nih.gov/medlineplus/ency/article/003377.htm

S12
Bernal-Mizrachi, C., Updated (2001 June 1, Updated). Growth hormone suppression test [16 paragraphs]. MEDLINEplus [On-line information]. Available FTP: http://www.nlm.nih.gov/medlineplus/ency/article/003376.htm

S13
Ruppe, M. (2002 February 23, Updated). Growth hormone [12 paragraphs]. MEDLINEplus [On-line information]. Available FTP: http://www.nlm.nih.gov/medlineplus/ency/article/003706.htm

S14
Health Resources: Neurosurgery://On-call (2000 February). Understanding Pituitary Tumors [11 paragraphs]. Patient Resources, Disorder of the Month, Pituitary Tumors Feature Article [On-line information]. Available FTP: http://www.neurosurgery.org/health/patient/detail.asp?DisorderID=19

S15
Pituitary Overview and Acromegaly [22 paragraphs]. The Hormone Foundation [On-line information]. Available FTP: http://www.hormone.org/learn/pituitary_1.html

S16
Anterior Pituitary Function [6 paragraphs]. The Merck Manual of Diagnosis and Therapy [On-line information]. Available FTP: http://www.merck.com/pubs/mmanual/section2/chapter6/6c.htm

S17
Bisp, K. (2001 September 13). Testing the integrity of the system - Growth potential and excess [10 paragraphs]. Society for Endocrinology, Endocrine Nurses Training Course [On-line information]. Available FTP: http://www.endocrinology.org/sfe/training/ent01/ent01_bis.htm

S18
Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby’s Diagnostic and Laboratory Test Reference, 8th Edition. Mosby, Inc., Saint Louis, MO. Pp. 506 – 510.

S19
Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry. AACC Press, Washington, DC. Grenache, D. and Willis, M., Chapter 31 Hypothalamic, Pituitary, and Gonadal Disorders. Pp. 351 – 363.

S20
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp. 502 – 510.

S21
Hurd, R. (2006 March 8, Updated). Growth Hormone [15 paragraphs]. MedlinePlus Medical Encyclopedia [On-line information]. Accessed on: 7/21/07. Available FTP: http://www.nlm.nih.gov/medlineplus/ency/article/003706.htm

S22
Van Voorhees, B. (2006 June 13, Updated). Growth hormone deficiency [17 paragraphs]. MedlinePlus Medical Encyclopedia [On-line information]. Accessed on: 7/21/07. Available FTP: http://www.nlm.nih.gov/medlineplus/ency/article/001176.htm

S23
Hurd, R. (2006 March 13, Updated). Growth hormone stimulation test [16 paragraphs]. MedlinePlus Medical Encyclopedia [On-line information]. Accessed on: 7/21/07. Available FTP: http://www.nlm.nih.gov/medlineplus/ency/article/003377.htm

S24
Hurd, R. (2006 March 13, Updated). Growth hormone suppression test [15 paragraphs]. MedlinePlus Medical Encyclopedia [On-line information]. Accessed on: 7/21/07. Available FTP: http://www.nlm.nih.gov/medlineplus/ency/article/003376.htm

S25
(2007 April). Acromegaly [24 paragraphs]. NIDDK. NIH Publication No. 02-3924 [On-line information, accessed September 2007]. Available FTP: http://www.niddk.nih.gov/health/endo/pubs/acro/acro.htm

S26
Leukemia and Lymphoma Society. Fact Sheet: Long Term and Late Effects of Treatment for Blood Cancers [Online information, accessed October 2007]. Available for download