血清γ谷氨酰转移酶水平与肥厚型心肌病心功能的相关性研究

Analysis of the relationship between serum level of gamma glutamyltransferase and left ventricular function in patients with hypertrophic cardiomyopathy

目的探讨肥厚型心肌病患者γ谷氨酰转移酶(GGT)与左心功能之间的关系。方法选取肥厚型心肌病(HCM)患者66例[男42例,女24例,平均年龄(59.11±12.13)岁]作为肥厚型心肌病组,按照性别和年龄匹配,年龄差距3岁之间,选取健康体检者66例[男42例,女24例,平均年龄(58.32±12.57)岁]为对照组。两组受试者均行血清学、心脏超声检测,记录血清GGT、血糖、血脂、左室舒张末内径(LVD)、左室射血分数(LVEF)、左心房容积(LAV)、二尖瓣舒张早期血流速度峰值(E值)、二尖瓣舒张晚期血流速度峰值(A值)、二尖瓣瓣环组织多普勒速度(E'),计算E/A、E/E'、左房容积指数(LAVI)。比较各指标组间差异性,分析血清GGT水平与超声检测指标的相关性。结果两组受试者LVEF比较,差异无统计学意义[(60.00±9.08)比(61.10±7.36),P>0.05];两组血清GGT[(32.35±15.58)μmol/L比(13.48±6.36)μmol/L]、LVD[(43.39±5.36)mm比(33.47±5.28)mm]、E/E'[(15.12±3.62)比(6.5±3.2)]、LAV[(53.69±20.27)m L比(30.64±8.9)m L]、LAVI[(38.42±15.27)m L/m2比(20.45±9.36)m L/m2]比较,差异有统计学意义(P<0.05),肥厚型心肌病组高于对照组。血清GGT水平与E/A、E/E'、LAV、LAVI呈正相关,相关系数分别为0.329、0.525、0.346、0.461(P<0.05);与LVEF无相关性(P>0.05)。结论血清GGT水平与肥厚型心肌病左室舒张功能具有相关性。血清GGT联合超声检测对肥厚型心肌病早期诊断及病程评估具有指导意义。

Objective To investigate the correlation between serum level of gamma glutamyltransferase （GGT） and left ventricular function in patients with hypertrophic cardiomyopathy （HCM）. Methods A total of 66 cases with HCM （42 males, 24 females, average age of （59.11±12.13） years] were enrolled as HCM group, and 66 healthy subjects [42 males, 24 females, average age of （58.32±12.57） years] were collected as control group match to the sex and age, the age gap was 3 years. The serum levels of GGT, TC, TG, GLU, and the sizes of LVD, LVEF, LAV, E, A, E＇ were deter-mined, and E/A, E/E＇, LAVI were calculated in all subjects. Differences of all parameters between the two groups were compared. The correlation between serum GGT levels and ultrasonic testing indicators were analyzed. Results There was no significant difference in LVEF between the two groups [（60.00±9.08） vs （61.10±7.36）, P〉0.05]. Significant dif-ferences were found in GGT levels [（32.35±15.58） μmol/L vs （13.48±6.36） μmol/L], sizes of LVD [（43.39±5.36） mm vs （33.47±5.28） mm], E/E＇ [（15.12±3.62） vs （6.5±3.2）], LAV [（53.69±20.27） mL vs （30.64±8.9） mL], LAVI [（38.42±15.27） mL/m2 vs （20.45±9.36） mL/m2] between the two groups, which in HCM group were higher than those in control group （P〈 0.05）. Serum GGT level was correlated with the size of E/A, E/E＇, LAV, LAVI, the correlation cofficient was 0.329, 0.525, 0.346, 0.461 （P〈0.05）, but not correlated with LVEF （P〉0.05）. Conclusion There is correlation between GGT and left ventricular diastolic function in patients with HCM. GGT level combined with echocardiography have guiding significance in early diagnosis and severity as-sessment of HCM.