重组人生长激素治疗15例原发性扩张型心肌病的初步观察

A preliminary study on rhGH in the therapy of idiopathic dilated cardiomyopathy

目的 观察重组人生长激素 (rh GH)对扩张型心肌病 (DCM)患者左心室形态及功能的影响、疗效及安全性。方法 2 8例 DCM心力衰竭患者随机分为 rh GH治疗组 (1 5例 )和对照组 (1 3例 )。两组病例均接受常规抗心衰治疗 (ACEI、利尿剂、地高辛 ) ,rh GH治疗组在常规抗心衰治疗的基础上肌肉注射 rh GH8.0 IU,每周 2～3次 ,共 3个月 ,治疗前后记录观测指标。以二维超声心动图、 X线胸片及心功能变化评价左心室形态及功能的改变。结果 rh GH治疗组 3个月后左心室舒张末期内径 (L VED)由治疗前 (70 .0 4± 2 .2 1 ) mm缩小至治疗后 (6 0 .2 0±2 .32 ) mm ,P<0 .0 1 ;心胸比率由治疗前 0 .6 6± 0 .0 6缩小至治疗后 0 .5 5± 0 .0 5 ,P<0 .0 1 ;左心室射血分数(L VEF)由治疗前 (31 .30± 2 .89) %提高到治疗后 (4 3.32± 4 .78) % ,P<0 .0 1。结论 初步临床观察表明 ,基因重组分泌型人生长激素对 DCM心力衰竭患者左心室形态及心功能改善具有一定的作用 。

Objective To study the effect of human recombinant growth hormone(rhGH)on the morphalogy and function of left cardiac ventricle in patients with idiopathic dilated cardiomyopathy(DCM).Methods\ Fifteen patients were treated only with both rhGH(8 0 IU biw or tiw,im)and routine therapy for heart failure,while thirteen patients were treated only with routine therapy for heart failure.The function and morphology of left cardiac ventricle were assessed with two dimensional echocardiography and X ray test after three months.Results\ rhGH improved left ventricular function,left ventricular ejection fraction(LVEF)significantly increased from (31 30±2 89)% to (43 32±4 78)%( P <0 01),left ventricular end dimension(LVED)decreased from 70 04±2 21mm to 60 20±2 32mm( P <0 01).The cardiothoracic ratio decreased from 0 66±0 06 to 0 55±0 05( P <0 01).Conclusion\ rhGH administered for three months to patients with DCM can increase the thickness of left ventricular wall and reduce LVED and improve LV function with no adverse events.