垂体功能减退症患者异常心电图分析

Abnormal electrocardiographic patterns and the prevalence of cardiovascular risk factors in females with hypopituitarism

目的研究垂体功能减退症女性患者的心电图异常表现及心血管危险因素的发生率。方法收集1998年10月至2010年12月就诊于北京大学人民医院的垂体功能减退症患者,女性患者组36例,平均年龄52.5岁(19～80岁),男性患者组14例,平均年龄为49.5岁(29～76岁)。比较两组患者的心电图异常表现及心血管危险因素。结果女性患者组与男性患者组相比,血浆GH、FSH、LH、ACTH、雌激素、PRL、TSH、FT3、FT4无显著性差异(p>0.05)。心电图异常表现中,女性患者中有8例窦性心动过缓,4例窦性心动过速,3例房室阻滞,1例房性早搏(房早),1例阵发性心房颤动(房颤),1例房性心动过速(房速),1例室性早搏(室早),1例室性心动过速(室速),1例心室颤动(室颤),1例右束支阻滞,1例病态窦房结综合征。男性患者中有2例右束支阻滞,1例窦性心动过缓,1例房早,1例室早。两组相比,心律失常发生率无明显差异。与男性相比,垂体功能减退症的女性患者甘油三酯水平及尿酸水平低(p<0.05)。36例女性患者中有6例合并心血管疾病,而14例男性患者中有8例合并心血管疾病,两组相比,垂体功能减退症女性患者发生心血管疾病的风险低(p=0.012)。两组患者的血电解质水平也无差异。结论垂体功能减退症女性患者的心电图异常表现,与男性患者相比,无明显差异;而心血管疾病危险因素中,女性比男性患者低,可能与女性患者的甘油三酯水平及尿酸水平低有关。

Objective To investigate abnormal electrocardiographic patterns as well as the prevalence of cardiovascular risk factors in females with hypopituitarism.Methods Thirty-six females with hypopituitarism for 19～80yr（median,52.5）compared to those in 14 males for 29～76yr（median,49.5）with hypopituitarism recruited from the People＇s Hospital of Peking University from Oct.1998 to Dec.2010.Abnormal electrocardiographic patterns were analyzed and the risk factors were also investigated.Results There is no difference in the level of serum GH,FSH,LH,ACTH,estradiol,PRL,TSH,free T4 and free T3（p0.05）between female and male groups.Eight females suffered sinus bradycardia,four sinus tachycardia,three atrioventricular block,one atrial premature beat,one paroxysmal atrial fibrillation,one ventricle premature beat,one atrial tachycardia,one ventricular tachycardia,one ventricular fibrillation,one right bundle branch block and one sick sinus syndrome,respectively.Two males suffered right bundle branch block,one sinus bradycardia,one atrial premature beat and one ventricle premature beat.However,there is no statistically difference between the two groups.Hypopituitary female patients had lower triglyceride level（p0.05）,and lower uric acid level（p0.05）.Six female patients had 8 diagnosed cardiovascular diseases compared to 8 in 8 male patients.By statistically,hypopituitary female patients had an decreased prevalence of cardiovascular risk factors（p=0.012）.Furthermore,the female patients had no difference for electrolyte measures compared to those in the male patients.Conclusions Hypopituitary females exhibit no differences in the incidence of abnormal electrocardiogram,but an decreased prevalence of cardiovascular risk factors.