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目的:探讨可乐定生长激素刺激试验(CGHST)在鉴别多系统萎缩(MSA)和原发性帕金森病(IPD)的应用价值。方法:对11例MSA-P和14例IPD患者清晨空腹仰卧安静状态下静脉采血,测定患者基础生长激素(GH)浓度;15 min以后口服盐酸可乐定300μg,以后每隔30 min连续采血4次测定血清GH浓度。根据ROC曲线确立最佳的截断值,计算其敏感度和特异度。结果:IPD患者口服可乐定后血清GH浓度显著增加,60 min时最为明显,平均值达(5.4±0.9)ng·μL~(-1)(P<0.001);而MSA-P患者服用可乐定以后血清GH基本保持稳定,最大增加值仅为(2.1±0.5)ng·μL~(-1)(P>0.05);比较两组间服用可乐定后30、60、90min血清GH水平,MSA-P患者血清GH增加值均显著低于IPD组(P<0.05);CGHST对MSA-P的敏感度和特异度分别是81.8%和85.7%。结论:CGHST可以作为MSA-p和IPD鉴别诊断的一种有效手段。
Objective: To investigate the value of clonidine growth hormone stimulation test (CGHST) in identifying multiple system atrophy (MSA) and primary Parkinson’s disease (IPD). Methods: 11 cases of MSA-P and 14 cases of IPD were collected in fasting venous blood in fasting resuscitation. The concentrations of basic growth hormone (GH) were determined. After 15 min, clonidine hydrochloride was given orally at 300 μg. Serum GH concentration was measured. According to the ROC curve to establish the best cut-off value, calculate the sensitivity and specificity. Results: Serum GH levels in patients with IPD were significantly increased after oral clonidine administration, with the most significant at 60 min, with an average of (5.4 ± 0.9) ng · μL -1 (P <0.001); while patients taking MSA-P received clonidine Serum GH levels remained stable at the maximum (2.1 ± 0.5) ng · μL -1 (P> 0.05) after 30, 60 and 90 minutes of clonidine administration. MSA- The serum GH levels in P patients were significantly lower than those in IPD patients (P <0.05). The sensitivity and specificity of CGHST to MSA-P were 81.8% and 85.7%, respectively. Conclusion: CGHST can be used as an effective method for differential diagnosis of MSA-p and IPD.