肢端肥大症患者GH与IGF-1负荷与心脏结构和功能改变的相关性

发布时间：2018-12-13 02:07

【摘要】：目的探讨肢端肥大症患者生长激素(GH)和胰岛素样生长因子1(IGF-1)负荷与心脏结构和功能改变的关系。方法回顾性分析99例肢端肥大症患者的临床资料,依据超声心动图检查结果,将患者分为参数异常组和正常组。采用Pearson相关性分析,探究患者的病程、平均GH、平均IGF-1、GH负荷、IGF-1负荷与超声心动检查中各项与心脏结构和功能有关参数的相关性。结果共有48例(48.5%)患者超声心动图存在异常,包括心腔扩大(29.3%)、瓣膜病变(15.1%)、主动脉根部增宽(5.1%)、左室收缩或舒张功能异常(19.2%)、室壁运动异常(1.0%)。参数异常组(n=48)的平均GH负荷普遍高于正常组(n=57),但仅左室收缩末内径(LVESD)与正常组差异有统计学意义(P=0.018);平均IGF-1负荷也普遍高于正常组,但仅二尖瓣口血流频谱峰值血流速度比值(E/A)(P=0.011)、左房前后径(LALD)(P=0.017)与正常组差异有统计学意义。将患者按照超声心动图诊断的舒张功能下降与否分为正常组(n=81)和异常组(n=18),正常组的GH负荷与异常组差异无统计学意义(P=0.419),而IGF-1负荷异常组高于正常组(P=0.018)。GH负荷与左室舒张末内径(LVEDD)、LVESD之间存在相关性(P0.05),IGF-1负荷与左心室射血分数(LVEF)、LALD、右室前后径(RVLD)、左室后壁厚度(LVPWT)、LVEDD、LVESD、E/A这7项参数之间存在相关性(P0.05)。结论 GH、IGF-1负荷可为评估肢端肥大症患者心血管系统并发症提供更好的评价指标。
[Abstract]:Objective to investigate the relationship between growth hormone (GH) and insulin-like growth factor 1 (IGF-1) load and changes of cardiac structure and function in patients with acromegaly. Methods the clinical data of 99 patients with acromegaly were analyzed retrospectively. According to the results of echocardiography, the patients were divided into two groups: abnormal parameter group and normal group. Pearson correlation analysis was used to explore the correlation between the course of disease, the average IGF-1,GH load of GH, the IGF-1 load and the parameters related to cardiac structure and function in echocardiography. Results there were 48 cases (48.5%) with abnormal echocardiography, including enlargement of cardiac cavity (29.3%), valvular disease (15.1%), enlargement of aortic root (5.1%). Left ventricular systolic or diastolic dysfunction (19.2%) and ventricular wall motion abnormality (1.0%). The average GH load in abnormal parameter group (nm48) was generally higher than that in normal group (nm57), but only the left ventricular end systolic diameter (LVESD) was significantly different from that in normal group (P0. 018). The mean IGF-1 load was also higher than that in the normal group, but only the peak flow velocity ratio of mitral orifice (E / A) and left atrial anterior and posterior diameter (LALD) (/ P0. 017) were significantly higher than those in the normal group. The patients were divided into normal group (n = 81) and abnormal group (n ~ (18) according to echocardiography. There was no significant difference in GH load between normal group and abnormal group (P _ (0.419). However, IGF-1 load was higher in abnormal group than that in normal group (P0. 018). GH load and left ventricular end diastolic diameter (LVEDD), LVESD) were correlated (P0.05), IGF-1 load and left ventricular ejection fraction (LVEF), LALD,) right ventricular anterior and posterior diameter (RVLD),). There was a correlation between the 7 parameters of left ventricular posterior wall thickness (LVPWT), LVEDD,LVESD,E/A) (P0.05). Conclusion GH,IGF-1 load may provide a better index for evaluating cardiovascular complications in patients with acromegaly.
【作者单位】：中国医学科学院北京协和医学院北京协和医院神经外科;
【分类号】：R584.11

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