60例肢端肥大症患者心脏结构和功能改变  

An Echocardiographic Study of Sixty Patients with Acromegaly

作　　者：李群[1] 王捷[1] 徐秀英[1] 李继红[1] 

机构地区：[1]首都医科大学附属北京天坛医院心血管内科

出　　处：《首都医科大学学报》2006年第2期214-217,共4页Journal of Capital Medical University

摘　　要：目的通过超声心动图检查,观察肢端肥大症患者心脏结构和功能的改变。方法选择60例肢端肥大症患者为实验组。选择34例性别和年龄相仿的健康者作为对照组。以上2组均行超声心动图检查,并做结果分析。将实验组中17例合并糖尿病和糖耐量减低者定为亚组病例,并进行亚组分析。结果1)实验组左心室舒张末期内径(LVIDd)、室间隔厚度(IVST)、左心室后壁厚度,心肌质量(LVM)及心肌质量指数(LVMi)较对照组明显增加,LVMi达到左心室肥厚(LVH)的比例为46.7%。经多元逐步回归分析,病程和血清生长激素(GH)浓度为心肌肥厚的主要影响因素。2)实验组射血分数(EF)和左心室短轴缩短率(FS)虽较对照组低,但仍在正常范围。3)实验组左心室等容舒张时间(IRT)和二尖瓣减速时间(MDT)较对照组明显延长。4)实验组中继发糖尿病/糖耐量减低(DM/IGT)组与非DM/IGT组进行比较,前者仅室间隔(IVST)有较明显增厚,其余各项参数2组间差异均无统计学意义。结论肢端肥大症患者心脏结构的改变,以心肌肥厚、心肌质量增加和心腔扩大为主。心脏功能的改变以舒张功能损害为主,而心脏收缩功能则可在较长时间内维持正常。Objective To investigate the alterations of cardiac structure and function in acromegalic patients by using echocardiography. Methods Sixty patients, diagnosed as acromegaly, were selected as research subjects. Thirty-four sex and age matched normal individuals were used as control, Patients and control groups underwent echocardiography. Besides, among the sixty patients, seventeen patients suffered from diabetes mellitus and impaired glucose tolerance, and were denoted as subgroup cases. The results of both were analysed. Results 1）Left ventricular mass（LVM） and LVM index（LVMi） were higher in patients with acromegaly than in control subjects, reaching values of left ventricular hypertrophy （46.7 %）. The patient group also showed apparent cardiac chambers enlargement. Through the multiple stepwise regression analysis, the duration of the disease and serum GH level were the main influencing factors of acromegalic cardiomyopathy. 2） Ejection fraction（EF） and fractional shortening （FS）, were decreased, compared to control group, they still remained in normal range. 3） Isovolumic relaxation time（IRT）and E wave descending time （MDT）, were delayed apparently compared to control group, indicating the damage of cardiac relaxation. 4）Subgroup analysis in acromegalic： The comparison between patients with diabetes mellitus and impaired glucose tolerance （DM/ IGT） and patients without DM/IGT showed that there was no significant difference in terms of the parameters in the two groups, in spite of an mild increase of IVST in the former group. Conclusion The echocardiographic alterations of cardiac structure mainly were LV hypertrophy and the increase of the LVM, the enlargement of the cardiac cambers. Changes of cardiac function mainly were the impairment of diastolic function. However, the systolic function still remained in normal range for a long time.

关 键 词：生长激素 肢端肥大症 超声心动图 心脏 

分 类 号：R584.11[医药卫生—内分泌]