肢端肥大症患者心脏超声改变及其影响因素  

Echocardiography features of Patients with Acromegaly matched with patients nonfunctional pituitary adenomas

作　　者：吴晓丹 林刁珠[2] 尤丽丽 张少玲[2] 郭颍 WU Xiao-dan;LIN Diao-zhu;YOU Li-li;ZHANG Shao-ling;GUO Ying(Zhou People's Hospital,Guangdong,510000;Department of Endocrinology,Sun yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou)

机构地区：[1]广东省潮州市人民医院,521000 [2]中山大学孙逸仙纪念医院内分泌科

出　　处：《岭南急诊医学杂志》2019年第6期564-567,共4页Lingnan Journal of Emergency Medicine

基　　金：国家自然科学基金(81970683);广东省自然科学基金(2018A030313596)

摘　　要：目的:目的回顾性分析肢端肥大症患者的心脏彩超,探讨其心脏结构改变及其相关的影响因素。方法:收集2013年1月至2018年12月中山大学孙逸仙纪念医院住院确诊为肢端肥大症的垂体生长激素瘤患者30例,以1∶1匹配性别、年龄、是否合并高血压、糖尿病、血脂异常的垂体无功能腺瘤患者30例为对照组,进行对比分析,进而研究肢端肥大症患者心脏结构改变的影响因素。结果:结果提示肢端肥大组其左心房内径[(36.57±7.38)mm vs(32.13±4.19)mm,P<0.05]、右室舒张末期内径[(21.87±3.06)mm vs(19.83±2.77)mm,P=0.05]、左室后壁厚度[(10.47±1.98)mm vs(9.57±1.89)mm,P=0.05]、左心室心肌重量[(206.61±85.64)g vs(32.78±75.82)g,P<0.05]、左心室心肌重量指数[(116.71±44.65)g/m^2vs(55.29±59.32)g/m^2,P<0.05]大于垂体无功能腺瘤组;logistic回归分析显示心脏扩大与年龄和尿酸有相关性,而与病程、高血压、生长激素(GH)无相关性。结论:与垂体无功能腺瘤患者相比较,肢端肥大症患者出现明显的心脏彩超结构的改变,主要是左心房、右心室增大及左心室肥厚。年龄和尿酸可能是该改变的主要影响因素。提示早期诊断和治疗,同时控制多种心血管危险因素是降低肢端肥大症患者心血管风险的有效手段。Objective:To investigate the alterations of cardiac structure and the risk factors in patients with acromegaly by retrospective analysis of patients*ec hoc arc!iography.Methods:From January 2013 to December 2018 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University,30 patients with growth hormone-secreting pituitary adenomas diagnosed as acromegaly(GHPA group)were selected and 30 patients with non-functioning pituitary adenomas as control group(NFPA group),to study the echocardiographic features in acromegaly and their influencing factors.Results:Cardiohypertrophy were found more popular in GHPA than NFPA group,with increased left atrial diameter[(36.57±7.38)mm vs(32.13±4」9)mm,P<0.05],right ventricular end-diastolic diameter[(21.87±3.06)mm vs(19.83±2.77)mm,P<0.05],left ventricular posterior wall thickness[(10.47±1.98)mm vs(9.57±1.89)mm,P<0.05],left ventricular mass[(206.61±85.64)g vs(132.78±75.82)g,Pv0.05]and left ventricular mass index[(116.71±44.65)g/m^2 vs(55.29±59.32)g/m^2,Pv0.05].The cardiac structural changes in patients with acromegaly are related to age and uric acid.Conclusion:Myocardial hypertrophy is the common cardiovascular comorbidities in acromegaly,which is related to GH levels and Coexistent cardiovascular risk factors including age and uric acid.The study highlights the importance of normalization of GH level and controlling cardiovascular comorbidities and risk factors as early as possible.

关 键 词：肢端肥大症 垂体生长激素瘤 心脏彩超 

分 类 号：R584.11[医药卫生—内分泌] R540.41[医药卫生—内科学]