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在患有低垂体和其他垂体疾病的患者中,QTc 间隔延长的决定因素
Valentina Gasco1, Daniela Cuboni1, Sergio Siclari1
1Department of Medical Science, Division of Endocrinology, Diabetes and Metabolism, University of Turin, 10126 Turin, Italy.
年龄和扩张性病变,不包括常见的垂体瘤,在患有下丘脑-垂体疾病的患者中预测延长QTc间隔. 电解质失衡也可能导致这种心血管风险.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
- 医学研究 医学研究
背景情况:
- 长QT综合征 (LQTS) 涉及心肌再极化延迟,增加了诸如torsades de pointes和突然心脏骤停等危及生命的心律失常的风险.
- 获得的LQTS (aLQTS) 越来越多地被怀疑是下垂体病的早期症状,可能解释了这些患者心血管死亡率的增加,尽管证据很少.
- 现有的数据将aLQTS与下垂体症联系起来,仅限于16份已发表的病例报告,需要进一步调查.
研究的目的:
- 为了研究下垂体和纠正的QT (QTc) 间隔之间的关联,在患有下垂体-下垂体疾病的患者中.
- 在这个患者队列中确定QTc间隔延长的关键预测因子.
主要方法:
- 追溯分析了185名患有下丘脑下垂体疾病的患者的数据,包括临床特征,激素替代疗法和实验室参数.
- 分析了12心电图,使用Bazett的公式计算了QTc.
- 使用多变量逻辑回归来确定QTc延长的预测因素.
主要成果:
- 高龄是多个模型中QTc延长的重要预测因素 (OR 1.07-1.09,p = 0.02).
- 扩张性病变,不包括垂体腺瘤,瘤和拉特克裂囊,与QTc延长有很强的关联 (OR 8.35-17.73,p < 0.05和p = 0.03).
- 低和阿尔伯明校正的水平显示一致,虽然边界,与QTc持续时间的关联 (p = 0.09和p = 0.06,分别).
结论:
- 年龄和特定扩张性病变的存在是患有下丘脑下垂体疾病的患者QTc持续时间的主要决定因素.
- 电解质失衡,特别是低血和低血,可能会加剧QTc延长.
- 特定垂体激素缺乏对QTc持续时间的直接影响尚不清楚,这可能是由于受研究的人群中有效的激素替代疗法.
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