慢性心力衰竭患者血清GH和IGFⅡ测定的意义

Serum Growth Hormone (GH) and Insulin-like Growth FactorⅡ (IGF-Ⅱ) in Chronic Heart Failure (CHF)

目的:探讨慢性心力衰竭患者血清生长激素(GH)和胰岛素样生长因子Ⅱ(IGFⅡ)变化及其临床意义。方法:用放射免疫分析测定了146例慢性心力衰竭(CHF)患者和50例非慢性心力衰竭患者的血清GH和IGFⅡ水平,并进行对照统计分析。结果:CHF组血清GH显著低于对照组(P<0.01),IGFⅡ水平显著高于对照组(P<0.01),两者间成显著负相关(r=-0.337,P<0.05)。在Ⅱ、Ⅲ、Ⅳ级组间,血清GH依次递减(FGH=40.88,P<0.01),IGFⅡ水平却依次递增(FIGFⅡ=3.208,P<0.05);GH水平在Ⅳ级组显著低于Ⅱ级组和Ⅲ级组(P<0.01),同时在Ⅲ级组显著低于Ⅱ级组(P<0.01);IGFⅡ水平在Ⅳ级组显著高于Ⅱ级组(P<0.05)。住院期间死亡组血清GH显著低于好转组(P<0.01),但IGFⅡ水平显著高于好转出院组(P<0.01)。结论:CHF患者血清GH显著降低,IGFⅡ显著升高,两者间成显著负相关。Ⅳ级组血清GH显著低于Ⅱ级组和Ⅲ级组,IGFⅡ则显著高于Ⅱ级组,住院期间死亡组血清GH显著降低,IGFⅡ水平显著升高。

Objective To investigate the changes of serum growth hormone (GH) and insulin-like growth factorⅡ(IGF-Ⅱ) levels in patients with CHF. Methods Serum GH and IGF-Ⅱ levels were studied with RIA in 146 cases of CHF and 50 controls. Results Serum GH levels in CHF patients were significantly lower and IGF-Ⅱ levels significantly higher than in the controls (both P<0.01). There was significantly negative correlationship between GH and IGF-Ⅱ levels (r=-0.337, P<0.05). The serum GH levels in patients with Grade Ⅳ cardiac function were signifiicantly lower than those in patients with Grade Ⅲ function; again, the levels in GradeⅢ patients were significantly lower than those in GradeⅡ patients (both P<0.01). For IGF-Ⅱ, the serum levels in GradeⅣ patients were significantly higher than those in GradeⅡ patients (P<0.05). In the patients succumbed in hospital, the serum GH levels were significantly lower and serum IGF-Ⅱ levels significantly higher than those in patients recovered finally (both P<0.01). Conclusion Serum GH levels were lowest and IGF-Ⅱ highest in those CHF patients with poorest cardiac function and highest mortality.