重组生长激素治疗扩张型心肌病的初步研究

A preliminary study recombinant growth hormone in treatment of dilated cardiomyopathy

目的 :进一步评价重组生长激素 (r-GH)治疗中、晚期扩张型心肌病 (DCM)的临床疗效。方法 :13例中晚期DCM在强心、利尿、扩管治疗的基础上接受 r-GH皮下注射 ,在基础治疗 3个月前后及 r-GH治疗 3个月后测定其血中三碘甲状腺原氨酸 (T3 )、四碘甲状腺原氨酸 (T4)、促甲状腺素 (TSH)、生长激素 (GH)、6-酮 -前列腺素 F1α(6-keto-PGF1α)浓度、患者的基本状况、心胸比率以及超声参数 ,采用自身对照进行比较 ,同时观察 r-GH的副作用。结果 :1基础治疗 3个月后 ,患者体重、心率、血压、NYHA心功能评级、心胸比率的变化与治疗前相比 ,无统计学意义(P>0 .0 5 )。 r-GH治疗后心率、NYHA心功能分级、心胸比率均降低 (分别为 P<0 .0 1,P<0 .0 1,P<0 .0 5 )。 2 r-GH治疗后血中 T3 ,GH,6-keto-PGF1α升高 (分别为 P<0 .0 5 ,P<0 .0 1,P<0 .0 1)。 3 r-GH治疗后心脏各腔室内径缩小 ,均有统计学意义 (均为 P<0 .0 5 ) ,左心室质量及左室射血分数增加 ,均有统计学意义 (均为 P<0 .0 5 )。结论 :r-GH治疗中、晚期 DCM有较好疗效 ,无明显不良反应。

AIM:To investigate the effect of recombinant growth hormone(r GH) therapy for dilated cardiomyopathy(DCM). METHODS:13 patients with moderate to late stage DCM were studies at base line after three months of conventional therapy and three months of r GH treatment . Thyroid hormone,growth hormone and prostacyclin were determined with immuoassay,and the heart thorax ratios were measured on chest x ray. Heart ultrasonic parameters were measured with echocardiography. Results were analysed with SPSS. RESULTS:①After three months of conventional therapy, no statistic significance was found in the changes of NYHA class,the heart thorax ratios and heart rate( P >0.05). After three months of r GH therapy,the parameters decreased( P <0.01 or P <0.05). ②After three months r GH therapy,the levels of T 3,GH,6 keto PGF 1α were much higher than the levels of this hormone at basic line and before r GH therapy( P <0.05, P <0.01, P <0.01)?③ After three months r GH treatment, the size of dilated chambers reduced( P >0.05),EF and LVM increased( P <0.05, P <0.05). CONCLUSION:r GH treatment is effective in moderate to late stage DCM.