Sartorio A, Ferrero S, Conti A, Bragato R, Malfatto G, Leonetti G, Faglia G
Laboratorio Sperimentale di Ricerche Endocrinologiche, Istituto Auxologico Italiano, IRCCS, Milano, Italy.
J Intern Med. 1997 Jun;241(6):515-20. doi: 10.1111/j.1365-2796.1997.tb00010.x.
To evaluate the effects of growth hormone deficiency (GHD) and of growth hormone (GH) therapy on cardiac structure in adults with childhood-onset GHD.
Out-patient clinic in the Italian Institute for Auxology, Milan.
Eight adults with childhood-onset GHD and eight healthy controls, matched for sex, age, exercise and body mass index.
Recombinant GH (Saizen Serono, Italy), administered in a conventional dose of 0.5 IU kg-1 week-1 for 6 months.
Cardiac structure parameters, evaluated by two-dimensional, M-mode and Doppler echocardiograms, and stress test, by means of a modified Bruce protocol with a bicycle ergometer, were determined before and after 6 months GH therapy.
Before treatment, mean (+/- SE) intraventricular septal thickness (IVST: 7.1 +/- 0.2 mm), LV posterior wall thickness (LVPT: 5.2 +/- 0.1 mm), LV mass (LVM: 94.6 +/- 5.0 g), LV mass index (LVM/body surface area, LVMI: 65.1 +/- 3.0 g m-2) and left ventricular end-diastolic diameter (LVED: 41.4 +/- 0.6 mm) of patients were significantly lower (P < 0.01) than in controls, whilst LV end-systolic diameter (LVES) of patients (25.5 +/- 0.7 mm) was similar to controls (27.5 +/- 0.7). GH treatment significantly (P < 0.01) increased LVPT (6.8 +/- 0.2 mm), LVM (111.6 +/- 4.6 g) and LVMI (80.5 +/- 3.5 g m-2); no significant changes were observed in LVED, LVES and IVST values. The stress test showed a significant improvement of cardiac performance, as demonstrated by the reduction of blood pressure x heart rate product at the same workload (basal: 32,722.5 +/- 897.4 vs. after: 25,574.6 +/- 439.7).
GH plays a role in the maintenance of a normal cardiac structure in adulthood. The present study suggests that GH treatment might be able to improve the cardiac structure of patients with childhood-onset GHD.
评估生长激素缺乏症（GHD）及生长激素（GH）治疗对儿童期起病的成年GHD患者心脏结构的影响。
米兰意大利辅助学研究所门诊。
8名儿童期起病的成年GHD患者及8名健康对照者，两组在性别、年龄、运动量和体重指数方面相匹配。
采用重组GH（意大利雪兰诺公司的赛增），以0.5IU/kg-1周-1的常规剂量给药，共6个月。
在GH治疗6个月前后，通过二维、M型和多普勒超声心动图评估心脏结构参数，并采用改良的布鲁斯方案通过自行车测力计进行负荷试验。
治疗前，患者的平均（±标准误）室间隔厚度（IVST：7.1±0.2mm）、左室后壁厚度（LVPT：5.2±0.1mm）、左室质量（LVM：94.6±5.0g）、左室质量指数（LVM/体表面积，LVMI：65.1±3.0g/m-2）和左室舒张末期内径（LVED：41.4±0.6mm）均显著低于对照组（P<0.01），而患者的左室收缩末期内径（LVES）（25.5±0.7mm）与对照组（27.5±0.7）相似。GH治疗显著（P<0.01）增加了LVPT（6.8±0.2mm）、LVM（111.6±4.6g）和LVMI（80.5±3.5g/m-2）；LVED、LVES和IVST值未见显著变化。负荷试验显示心脏功能有显著改善，在相同工作量下血压×心率乘积降低（基础值：32722.5±897.4 vs. 治疗后：25574.6±439.7）即可证明。
GH在维持成年期正常心脏结构中起作用。本研究表明，GH治疗可能能够改善儿童期起病的GHD患者的心脏结构。
