CAJ | 학술논문

目的探讨肢端肥大症患者的心房心室腔及大血管内径的变化情况及其相关危险因素.方法选取2013年1至12月在北京协和医院神经外科确诊为肢端肥大症的92例患者(试验组),其中男37例,女55例,年龄19 ～67(41±13)岁,并根据试验组性别、年龄选取92例健康体检者作为对照组,采集两组患者相关病史、超声心动图及内分泌激素检查等信息进行对比分析,并采用二元logistic回归分析筛选与发生大血管内径扩大相关的危险因素,得出OR值及预测模型.结果试验组患者的左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)、左房前后径(LALD)、右室前后径(RVLD)、主动脉根部内径(AORD)、升主动脉内径(AA)及主肺动脉内径(MPA)均较对照组有明显扩大,P ＜0.05;其中试验组的大血管内径扩大者(ADE)与内径正常者的病程(月)对比差异有统计学意义(121 ±70比73±59,P＜0.05,OR=1.011),建立回归方程为:logit (ADE)=-3.420 +0.011×病程.结论肢端肥大症患者心腔及大血管内径较正常人有扩大,其中大血管内径扩大与病程长短有关,与GH、IGF-1高低无关,病程时间长是其危险因素.
목적 탐토지단비대증환자적심방심실강급대혈관내경적변화정황급기상관위험인소.방법 선취2013년1지12월재북경협화의원신경외과학진위지단비대증적92례환자(시험조),기중남37례,녀55례,년령19 ～67(41±13)세,병근거시험조성별、년령선취92례건강체검자작위대조조,채집량조환자상관병사、초성심동도급내분비격소검사등신식진행대비분석,병채용이원logistic회귀분석사선여발생대혈관내경확대상관적위험인소,득출OR치급예측모형.결과 시험조환자적좌실수축말내경(LVESD)、좌실서장말내경(LVEDD)、좌방전후경(LALD)、우실전후경(RVLD)、주동맥근부내경(AORD)、승주동맥내경(AA)급주폐동맥내경(MPA)균교대조조유명현확대,P ＜0.05;기중시험조적대혈관내경확대자(ADE)여내경정상자적병정(월)대비차이유통계학의의(121 ±70비73±59,P＜0.05,OR=1.011),건립회귀방정위:logit (ADE)=-3.420 +0.011×병정.결론 지단비대증환자심강급대혈관내경교정상인유확대,기중대혈관내경확대여병정장단유관,여GH、IGF-1고저무관,병정시간장시기위험인소.
Objective To investigate alternations of heart cavity and great vessel diameters and their risk factors in acromegalic patients.Methods Ninety-two cases,diagnosed as acromegaly,were selected as research subjects from January 2013 to December 2013 in Peking Union Medical College Hospital.There were 37 males and 55 females with an average age of 41.2 years (SD,12.5 years,range from 19 to 67 years old).Ninety-two sex and age matched healthy individuals were selected as controls.Disease history,echocardiography,endocrine hormone levels were collected to make contrastive analysis.We analyzed the related risk factors of great vessel diameters expansion with binary logistic regression analysis and finally obtained the OR (odd ratio) and predictive formula.Results Left ventricle enddiastolic diameter (LVEDD),left ventricle end-systolic diameter (LVESD),left atrium longitudinal dimension (LALD),right ventricle longitudinal dimension (RVLD),aortic root dimension (AORD),ascending aorta (AA),main pulmonary artery (MPA) were higher in patients with acromegaly than in healthy people,P ＜ 0.05.The comparison between expanded vessel diameters and normal vessel diameters in acromegalics showed that difference of disease duration was of statistical significance,OR =1.011.We got the formula:logit (ADE) =-3.420 + 0.011 × duration of disease.Conclusion Heart cavity and vessel diameters in acromegalic patients were higher than that in public.Expanding of great vessel diameters mainly depend on duration of disease instead of serum GH and IGF-1 level,and the duration of disease is the risk factor of the expansion of great vessel diameters.