Insulin hypoglycemia excited GH, ACTH test
Insulin hypoglycemia excitatory GH, ACTH test is carried out by the following principle, hypoglycemia is a very strong stress factor for the hypothalamus-pituitary. In normal people, when blood glucose drops below 2.2mmol/L, the secretion of GH, ACTH-cortisol, TSH and catecholamine is significantly excited. This test uses a standard amount of insulin to induce hypoglycemia to detect the reserve function of GH, and also to measure the function of the pituitary-adrenal axis and pituitary-thyroid axis. Basic Information Specialist classification: growth and development check classification: endocrine examination Applicable gender: whether men and women apply fasting: fasting Tips: Inappropriate people: coronary heart disease, uncorrected severe hypothyroidism and Addison's disease. Normal value [Normal value] Normal human serum GH elevation ≥ 5ug / L, GH peak <75ug / L, suggesting a serious deficiency of GH. Clinical significance About 70% of normal people respond. Abnormal results: hypothalamic-pituitary lesions, GH reserve function abnormalities, pituitary-adrenal axis dysfunction, pituitary-thyroid axis dysfunction, etc. caused the test results to be out of normal values. The person to be examined: to identify whether the pituitary growth hormone tumor resection surgery recurrence phenomenon, as well as the above-mentioned hypothalamic-pituitary lesions, GH reserve function abnormalities and other related diseases. Precautions Requirements for inspection: Actively cooperate with the doctor's request. 1. After the end of the test, immediately drink 20 grams of glucose water, and then enter breakfast. If the patient has the possibility of hypopituitarism, prednisone 5mg should be added and eaten every 4 hours on the same day. 2. If angina pectoris, shock or loss of consciousness occurs during the test, the test should be terminated immediately. Intravenous injection of 50% glucose 60ml (at the same time, blood is taken from another arm), if the patient can not recover, intravenous glucagon 0.5-1mg . 3. The patient's blood pressure, pulse and consciousness changes should be closely observed during the test. Inspection process [Method] Fasting overnight, bed rest, blood sampling, TSH, ACTH and GH, intravenous insulin 0.1 unit / kg body weight (pituitary dwarf), 0.3 units / kg body weight (obesity, acromegaly, Cushing Syndrome, diabetes, blood glucose and GH were measured at 0, 30, 60, 90 minutes, and ACTH was measured when hypoglycemia occurred. [Results] The serum GH of patients increased by 0.4ug/L, and the peak value of GH was 1.2ug/L, which was lower than that of normal people, indicating that the pituitary growth hormone tumor surgery was thorough and no recurrence. Another ACTH rises after excitement, indicating that the pituitary adrenocorticotropic hormone cells have a certain reserve function. Not suitable for the crowd Inappropriate population: coronary heart disease, uncorrected severe hypothyroidism and Addison's disease, diabetes, fasting blood glucose > 8.3mmol / L. Adverse reactions and risks No obvious complications and harms.
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