垂体瘤切除术对垂体瘤并发心脏扩大患者心功能的影响

The cardiac function changes before and after pituitary tumor resection in patients with pituitaryadenoma complicated with dilated cardiomyopathy

目的回顾分析垂体瘤切除术对垂体瘤并发心脏扩大患者的心功能变化的影响。方法收集解放军总医院2005-2011年经垂体瘤切除术治疗的14例垂体腺瘤并发心脏扩大患者临床资料，对比分析手术前后患者心功能情况及术后恢复情况，利用超声心动图等无创检测手段检测患者术前及术后血清生长激素（GH）、左室舒张末期内径（LVEDD）、室间隔厚度（sT）、左室后壁厚度（LVPwT）和左室射血分数（LVEF），进行对比分析。结果垂体瘤切除术后GH、ST、LVEF、LVPwT平均值较术前均显著改善（分别为GH93．89wg／L比5．16μg∥L、ST11．13mm比10．64mm、LVEF43．92％比49．28％、LVPWT10．53mm比8．87mm）。手术前后GH差值与手术前后ST、LVEDD、LVEF差值呈线性关系，与手术前后LVEF差值呈正相关，与手术前后LVEDD和sT差值呈负相关。结论垂体瘤切除术用于治疗垂体腺瘤并发心脏扩大可显著改善患者心功能，其心功能恢复程度和手术前后GH差值关系明显。

Objective To evaluate the cardiac function changing before and after resection of pituitary tumor in patients with pituitary adenoma complicated with dilated cardiomyopathy with retrospective analysis method. Methods The clinical data of 14 cases of patients with pituitary adenoma complicated with dilated cardiomyopathy, treated with resection of pituitary tumor, in PLA General Hospital, from 2005 to 2011, were collected and analyzed. Comparative analysis of cardiac function were made in these patients before and after the surgery, also with the postoperative recovery status, using echocardiography and other noninvasive detection means to detect the growth hormone （ GH ） , left ventricular end-diastolic diameter （LVEDD）, septal thickness （ST）, left ventricular posterior wall thickness （LVPWT） , left ventricular ejection fraction （LVEF） values. Results After the resection of pituitary tumor, the LVEDD, ST, LVPWT, LVEF levels were all significantly better than that before the surgery. Before the surgery the GH, ST, LVPWT, LVEF levels were 93.89 μg/L,11. 13 mm, 43.92% and 10. 53 ram, while those after the surgery were 5.16μg/L, 10. 64 mm ,49.28% and 8.87 mm. The difference of the GH level before and after the surgery was correlated with the difference of ST, LVEDD and LVEF in a linear manner. Conclusions Recection of pituitary tumor can significantly improve the cardiac function in patients with pituitary adenoma complicated with dilated cardiomyopathy, and the cardiac function improving level is correlated with the difference of GH levels before and after the surgery.