生长激素对心功能作用的探讨

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。

Effect of growth hormone on cardiac performance

Objective To evaluate the effect ofgrowth 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. GH treatment remarkably improved cardiac performance in these patients.