论文部分内容阅读
目的:应用超声二维应变成像技术评价甲状腺功能亢进(甲亢)患者右室纵向收缩功能。方法:根据甲亢的临床症状和相关辅助检查分为单纯性甲亢组(43例)和甲亢性心脏病组(20例),正常对照组33例。经胸采集并存贮3个心动周期标准心尖四腔二维图像,运用EchoPAC超声工作站进行脱机分析,在二维应变的模式下,测量右室游离壁和室间隔右室面基底段、中间段及心尖段6个节段的纵向收缩期峰值应变和右室整体收缩峰值应变值,并比较各收缩期峰值应变在3组间的差异。同时测量并分析右室舒张末横径(RVED)、右室射血分数(RVEF)、右室面积变化率(RVPCA)及三尖瓣环收缩期峰值速度(TVSPV)等指标与右室整体收缩峰值应变的相关性。结果:甲亢性心脏病组右室游离壁及室间隔基底段、中间段、心尖段及右室整体的收缩期峰值应变较正常对照组和单纯性甲亢组均显著减低,差异具有统计学意义(P<0.001);单纯性甲亢组右室游离壁及室间隔基底段、中间段、心尖段及右室整体的收缩期峰值应变较正常对照组稍减低,但差异无统计学意义(P>0.05);RVED、RVEF、RVPCA及TVSPV与右室整体收缩期峰值应变均具有良好的相关性(r分别为=-0.355、0.351、0.398和0.292,均P<0.01)。结论:超声二维应变成像技术能够准确定量评价甲亢患者右室长轴收缩功能,为临床评价右心功能提供了又一有效方法。
Objective: To evaluate the right ventricular longitudinal systolic function in patients with hyperthyroidism (Hyperthyroidism) by using two-dimensional ultrasound imaging. Methods: According to the clinical symptoms and related auxiliary examination of hyperthyroidism, the patients were divided into simple hyperthyroidism group (43 cases) and hyperthyroid heart disease group (20 cases), and normal control group (33 cases). Three standard two-dimensional images of apical four-chamber cardiac cycle were collected and stored in the transthoracic. EchoPAC workstation was used for offline analysis. In the two-dimensional strain mode, the right ventricular free wall and the basal section of the right ventricular septum were measured. And the peak systolic strain of the systolic phase and the peak systolic strain of the right ventricle in 6 segments of the apical segment. The differences of the peak strain in each systolic phase among the 3 groups were also compared. At the same time, RVED, RVEF, RVPCA and tricuspid annulus systolic peak velocity (TVSPV) were measured and analyzed. Correlation of peak strain. Results: Compared with normal control group and simple hyperthyroidism group, peak systolic peak strain of right ventricular free wall and basal segment, middle segment, apical segment and right ventricle in Hyperthyroid heart disease group were significantly decreased (P < P <0.001). The systolic peak strain of right ventricular free wall and basal segment, middle segment, apical segment and right ventricle of Hyperthyroidism group were slightly lower than those of normal control group, but the difference was not statistically significant (P> 0.05 (R = -0.355,0.351,0.398, and 0.292, respectively, P <0.01). The RVED, RVEF, RVPCA and TVSPV had a good correlation with the peak systolic strain of the right ventricle. Conclusion: The two-dimensional ultrasound imaging technique can accurately quantify the systolic function of the right ventricular long axis in patients with hyperthyroidism and provide another effective method for clinical evaluation of right ventricular function.