重组人生长激素治疗原发性扩张型心肌病初步研究

EFFECT OF RECOMBINANT HUMAN GROWTH HORMONEIN PATIENTS WITH DILATED CARDIOMYOPATHY

目的 :观察重组人生长激素 (rhGH )对原发性扩张型心肌病 (DCM )的疗效及安全性。方法 :2 6例中、重度DCM患者分为rhGH治疗组 (18例 ) ,安慰剂治疗组 (8例 )。在常规抗心衰治疗基础上 ,治疗组给予rhGH 4.5Iu ,im ,qod ,安慰剂组给予生理盐水 2mL ,im ,qod ,观察用药 3个月前后的心功能状态 ,左室射血分数 (LVEF)、左室大小、心胸比例、运动耐量、心率、心律失常等的变化情况。结果 :rhGH治疗组心功能改善总有效率为 72 7% ,左室射血分数 (LVEF)由 2 5 8± 6 5 %增至 3 8 7± 8 6% ,左室内径缩小 ,左室舒张末径 (LVEDd)由 69 5± 6 2mm减为66 3± 8 9mm ,运动耐量由 6min 3 91± 82m增至 495± 90m ,其它指标亦有明显改善 ,较安慰剂组有显著性差异(P <0 0 1)。结论 :rhGH对DCM心衰患者具有一定改善心功能作用 ,为DCM患者提供了一种新的安全有效的治疗方法。

Objective:To evaluate the therapeutic effect of recombinant human growth hormone (rhGH)in patients with dilated cardiomyopathy (DCM).Method:Twenty-six DCM patients from mild to heavy grade were divided randomly into rhGH-group (18 cases) and placebo-group (8 cases).In addition to conventional heart failure therapy,rhGH was administered intramuscularly at 4.5 IU in rhGH-group and saline solution intramuscularly at 2 ml in placebo-group every other day,respectively.After 3 months,we evaluated the changes of left ventricular function,left ventricular ejection fraction (LVEF),left ventricular dimension,left ventricular end-diastolic dimension (LVEDd),ratio of heart to chest,heart rate,arrhythmia and movement capability.Results:In the rhGH-group after rhGH treatment,the effective rate of left ventricular function improvement (72.7%),increases in LVEF (from 25.8+/-6.5% to 38.7+/-8.6%,P<0 01) and movement capability of 6 minutes (from 391+/-82 to 495+/-90 M,P<0 01),and decreases in LVEDd (from 69.5+/-6.2 to 66.3+/-8.9 MM,P<0 01) and left ventricular dimension were observed.Conclusion:rhGH therapy can improve the heart function for DCM patients with heart failure.This may provide a new therapeutic way for DCM patients.