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张 硕, 李一琳, 郭晓鹏, 等.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.四川大学学报(医学版),2017,48(3):431-434
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
Association of GH and IGF-1 Burden with Cardiac Structural and Functional Changes in Acromegaly Patients
  
中文关键词:  肢端肥大症 生长激素 胰岛素样生长因子1 超声心动图 心脏
英文关键词:Acromegaly Growth hormone Insulin-like growth factor 1 Echocardiography Heart
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中文摘要:
      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(P<0.05),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(P<0.05)。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。
英文摘要:
      Objective To investigate the association of growth hormone (GH) and insulin-like growth factor (IGF-1) burden with the cardiac structural and functional changes in acromegaly patients. Methods Ninety-nine acromegaly patients were enrolled in this study. According to the normal range of echocardiographic parameters of Peking Union Medical College Hospital, the patients were divided into parameter normal group and abnormal group. Correlation analyses were conducted between duration of disease, mean GH, mean IGF-1, GH burden, IGF-1 burden and echocardiography data retrospectively. Results Forty eight cases (48.5%) was diagnosed as abnormal echocardiography, including enlargement of the cardiac cambers (29.3%), valvular diseases (15.1%), dilation of aortic root (5.1%), functional abnormal of left ventricle (19.2%) and wall motion abnormalities (1.0%). The average GH and IGF-1 burdens in echocardiography abnormal group (n=48) were higher than those in the normal group (n=51), without statistical significant except for the left ventricle end-systolic diameter (LVESD) (P=0.018) in GH burden comparison and E/A (P=0.011) and left atrium longitudinal dimension (LALD) (P=0.017) in IGF-1 burden comparison. Abnormal diastolic function group (n=18) had similar GH burden with the normal group (n=81) (P=0.419), but had higher IGF-1 burden than the normal group did (P=0.018).The GH burden correlated with left ventricle end-diastolic diameter (LVEDD) and LVESD,and the IGF-1 burden correlated with left ventricular ejection fraction (LVEF) , LALD, right ventricle longitudinal dimension( RVLD), Left ventricular posterior wall thickness (LVPWT), LVEDD, LVESD,and E/A ratio statistical significantlly (P<0.05). Conclusion There exist associations of GH and IGF-1 burden with echocardiography abnormalities and cardiac complications.
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