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心脏功能可能会受到损害的患者高血水平二次金属对金属部植入物
Mark R J Jenkinson1, Dominic R M Meek1, Rothwelle Tate2
1Queen Elizabeth University Hospital, Glasgow, UK.
金属对金属的部植入物可以导致高水平,可能导致心脏问题. 这项研究发现,全球纵向应变 (GLS) 是一种敏感的测量方法,在患有这些植入物导致高水平的患者中显示出心脏功能受损.
科学领域:
- 心脏病学 心脏病学
- 生物材料科学 生物材料科学
- 整形外科手术 整形外科手术
背景情况:
- 金属对金属 (MoM) 关节置换术与血液中含量升高有关.
- 这些高的含量是心血管并发症的疑似危险因素,包括心肌病.
- 之前使用左心室喷射分数 (LVEF) 的研究已经产生了关于诱导心肌病的相互矛盾的证据.
研究的目的:
- 为了研究心血管损伤的程度,以全球纵向应变 (GLS) 测量,在患有MoM部植入物二次性高血水平的患者中.
- 使用GLS评估血液中的含量与心脏功能之间的相关性.
- 在MoM部植入物和高水平的患者中比较GLS和LVEF.
主要方法:
- 确定了一个由16名患者组成的队列,其血液中的含量>13μg/l来自MoM关节置换术.
- 八名等待关节整形手术的患者作为对照组.
- 所有患者都接受了心声回声,包括GLS和LVEF测量.
主要成果:
- 与对照组 (0.01μg/l) 相比,使用MoM部植入器的患者的平均血液含量显著更高 (29μg/l).
- 全球纵向应变 (GLS) 在MoM队列 (-15.5%) 与对照组 (-18%) 相比显著较低,表明心脏功能受损 (p=0.025).
- GLS与血液中的含量有很强的正相关性 (r=0.8521;p<0.001),而LVEF在不同组之间没有差异.
结论:
- 在MoM部植入体患者中,血中含量升高 (>13μg/l) 与心脏功能受损有关,如GLS检测的那样.
- 这是第一个利用GLS的研究,一个更敏感的回声心脏学参数,以确定MoM部植入物和正常LVEF患者的心脏收缩功能障碍.
- 建议对更大的队列进行进一步的研究,以确定GLS作为MoM关节塑造术患者心脏并发症的预测因素.
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