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生长激素对心功能作用的探讨 |
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叶军 沈永年 黄晓东 李劲松 吴靖川 陈瑞冠
【摘要】 目的 探讨生长激素(GH)对心功能的作用。方法 用平衡法核素心血池显象技术及运动试验对特发性生长激素缺乏症(IGHD)患者在GH治疗前后进行左心室功能评价。结果 67例儿童及青 少年两组患者左心室 总体射血分数(LVEF) 明显低于对照组(分 别为P＜0.05及P＜0.01)，青少年组其左心室舒张末期高峰充盈率(PFR)也显著低于对照组(P＜0.05)；35例(52.2%)左心室总体收缩或(和)舒张功能降低；29例(47.3%)运动试验后出现心率、ST段及T波异常。13例心功能异常者接受重组人生长激素(rhGH)治疗6个月后，LVEF及PFR较治疗前显著提高(分别为P＜0.05及P＜0.01)。结论 约半数生长激素缺乏症(GHD)患者在没有GH治疗的情况下，其左心室收缩和舒张功能明显受损，并伴有心肌缺血和劳损。GH治疗可显著改善GHD患者的心功能。
【关键词】 生长激素 生长激素缺乏症 心功能 放射性核素显像
Effect of growth hormone on cardiac performance
YE Jun,SHEN Yongnian,HUANG Xiaodong,et al.
Shanghai Institute for Pediatric Research,Shanghai,200092
【Abstract】 Objective To evaluate the effect of growth hormone(GH) on cardiac function. Methods Cardiac performance was investigated by equilibrium radionuclide angiography and exercise tolerance test before and after GH treatment in 67 patients with idiopathic growth hormone deficiency(IGHD) and in 10 healthy children. Results The total ejection fraction of left ventricle (LVEF) was greatly reduced in the 67 childhood and adolescent patients (P＜0.05 and P＜0.01 respectively) and the peak filling rate(PFR) in the end-diastolic phase were remarkably reduced in the adolescent group (P＜0.05) as compared with the control group; The total systolic and/or diastolic function of left ventricle was significantly decreased in 35 (52.2%) IGHD patients. Moreover, 29 of 60 (47.3%) patients were found to have abnormal heart rate, depressed ST segment and changed T wave in electrocardiogram profiles after exercise tolerance test. On the other hand, 13 patients with abnormal cardiac function had been treated with recombinant human growth hormone (rhGH) for 6 months and their systolic and diastolic functions of left ventricle were significantly improved (P＜0.05 and P＜0.01 respectively). Conclusions About half of the patients with primary GHD, who have not been treated with rhGH, had an impaired left ventricle function. [1] [2] 下一页
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