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【JCEM】长期多巴胺激动剂治疗引起瓣膜病变
Objective: Treatment with ergot-derived dopamine agonists, pergolide, and cabergoline has been associated with an increased frequency of valvular heart disease in Parkinson’s disease. The aim of the present study was to assess the prevalence of valvular heart disease in patients treated with dopamine agonists for prolactinomas.
Design: This was a cross-sectional study.
Patients: We performed two-dimensional and Doppler echocardiography in 78 consecutive patients with prolactinoma (mean age 47 ± 1.4 yr, 26% male, 31% macroprolactinoma) treated with dopamine agonists for at least 1 yr (mean 8 ± 0.6 yr) and 78 control subjects. Patients were classified according to treatment: patients treated with cabergoline (group 1: n = 47) and patients not treated with cabergoline (group 2: n = 31).
Results: Clinically relevant valvular heart disease was present in 12% of patients (nine of 78) vs. 17% of controls (13 of 78) (P = 0.141) and 17% (eight of 47) of patients treated with cabergoline vs. 3% (one of 31) of patients not treated with cabergoline (P = 0.062). Mild tricuspid regurgitation was present in 41% of patients vs. 26% of controls (P = 0.042), and aortic valve calcification was present in 40% of patients, compared with 18% of controls (P = 0.003). There was no relation between the cumulative dose of cabergoline and the presence of mild, moderate, or severe valve regurgitation.
Conclusion: Several years of dopamine agonist treatment in patients with prolactinomas is associated with increased prevalence of aortic valve calcification and mild tricuspid regurgitation but not with clinically relevant valvular heart disease. Therefore, additional studies on the adverse cardiac effects of dopaminergic drugs in prolactinoma are warranted, especially in patients with much longer use of these drugs. 认领此文编译，24小时内交稿。
Aortic Valve Calcification and Mild Tricuspid Regurgitation But No Clinical Heart Disease after 8 Years of Dopamine Agonist Therapy for Prolactinoma
使用多巴胺激动剂治疗泌乳素瘤8年后大动脉瓣膜钙化和轻度三尖瓣返流但没有临床心脏病。
Objective: Treatment with ergot-derived dopamine agonists, pergolide, and cabergoline has been associated with an increased frequency of valvular heart disease in Parkinson’s disease. The aim of the present study was to assess the prevalence of valvular heart disease in patients treated with dopamine agonists for prolactinomas.
目的：使用麦角衍生的多巴胺激动剂，已经证实帕金森病人使用培高利特和卡麦角林可能增加瓣膜心脏病。目前的研究目的是评估使用多巴胺激动剂治疗的泌乳素瘤病人瓣膜性心脏病的患病率。
Design: This was a cross-sectional study.
设计：这是一项代表性研究。
Patients: We performed two-dimensional and Doppler echocardiography in 78 consecutive patients with prolactinoma (mean age 47 ± 1.4 yr, 26% male, 31% macroprolactinoma) treated with dopamine agonists for at least 1 yr (mean 8 ± 0.6 yr) and 78 control subjects. Patients were classified according to treatment: patients treated with cabergoline (group 1: n = 47) and patients not treated with cabergoline (group 2: n = 31).
病人：我们为78例（平均年龄47± 1.4岁，26%为男性，31为巨泌乳素瘤）使用多巴胺激动剂治疗泌乳素瘤病人和78例对照组进行连续性的二维多普勒心脏超声检查至少一年（平均8 ± 0.6年）。病人分为使用卡麦角林（组1：47人）和非使用卡麦角林（组2：37人）两组。
Results: Clinically relevant valvular heart disease was present in 12% of patients (nine of 78) vs. 17% of controls (13 of 78) (P = 0.141) and 17% (eight of 47) of patients treated with cabergoline vs. 3% (one of 31) of patients not treated with cabergoline (P = 0.062). Mild tricuspid regurgitation was present in 41% of patients vs. 26% of controls (P = 0.042), and aortic valve calcification was present in 40% of patients, compared with 18% of controls (P = 0.003). There was no relation between the cumulative dose of cabergoline and the presence of mild, moderate, or severe valve regurgitation.
结果：临床瓣膜性心脏病发生在12%的病人（9/78），17%的对照组（13/78）(P = 0.141)和17%的使用卡麦角林治疗的病人（8/47）对比3%（1/31）未使用卡麦角林治疗的病人（P = 0.062）。中度三尖瓣返流发生在41%的病人和26%的对照组（P = 0.042），动脉瓣膜钙化发生在40%的病人和18%的对照组（P = 0.003)。卡麦角林的累积剂量和轻度、中度、重度瓣膜返流无明显相关。
Conclusion: Several years of dopamine agonist treatment in patients with prolactinomas is associated with increased prevalence of aortic valve calcification and mild tricuspid regurgitation but not with clinically relevant valvular heart disease. Therefore, additional studies on the adverse cardiac effects of dopaminergic drugs in prolactinoma are warranted, especially in patients with much longer use of these drugs.
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作者:admin@医学,生命科学 2010-10-29 05:11
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