摘要
目的::探讨定量组织速度成像(QTVI)技术评价甲亢患者左心室收缩和舒张功能的临床价值。方法:选取甲亢患者53例,根据甲亢性心脏病的临床诊断标准将其分为单纯甲亢32例和甲亢性心脏病21例,同时选取40例正常人作为对照组。常规超声心动图测量左房收缩末期最大内径(LAd)、左室舒张期末期最大内径(LVEDd)、左室后壁厚度(LVPWd)、左室射血分数(LVEF)以及二尖瓣口舒张早期峰值速度(E)、舒张晚期峰值速度(A)及其比值(E/A);运用QTVI对左心室各心肌节段的速度曲线进行分析,获得左心室心肌二尖瓣环处的收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)和舒张晚期的峰值速度(Va)及其比值(Ve/Va)。结果:与正常对照组相比,单纯甲亢组LAd、LVPWd及LVEF差异具有统计学意义(P<0.05),甲亢心组LAd、LVEDd、E、A和E/A差异具有统计学意义(P<0.05);QTVI测值比较:单纯甲亢组Vs、Va的测值与正常对照组比明显增高,Ve/Va与正常对照组比明显减低,差异均具有统计学意义(P<0.01);甲亢心组测量Vs、Ve、Ve/Va与正常对照组比较均明显减低,差异有统计学意义(P<0.01)。结论:和常规超声参数相比,QTVI技术可定量检测甲亢所致的左心室收缩和舒张功能异常,Ve/Va是反映甲亢所致早期心脏心肌舒张功能损害的敏感性较好的指标,Vs是反映甲亢性心脏病患者左室收缩功能损害的敏感性指标。
Objective.. To evaluate the left ventricular function in patients with hyperthyroidism by quantitative tissue velocity imaging（QTVI）. Methods： According to the clinical diagnostic standard, 53 pa- tients with hyperthyroidism were divided into hyperthyrod heart disease group and the non-hyperthyrodheart disease group, and 40 normal subjects served as the control. Conventional two-dimensional eehocar- diography was performed on all subjects to obtain the left atrial end systolic diameter （LAd）, the left ven- trieular end diastolic diameter （LVEDd）, left ventricular posterior wall diameter （LVPWd） and left ven- tricular ejection fraction （LVEF）. The transmittal flow was obtained by pulsed-wave Doppler, and the peak velocity of the early （E） and later （A） diastolic waves were measured, then the ratio of E/A was cal- culated. The TDI pictures of apical views （2, 3, and 4 chambers） for three stable and consecutive cardiac cycles were stored and transferred to Echo PAC （GE Hearth care） for analysis. Peak systolic velocity of left ventricular mitral annulus （Vs）, early diastolic peak velocity （Ve） and late diastolic peak velocity （Va） and the ratio （Ve/Va） were measured. Results： Compared with the normal group, the LAd, LVP- Wd and LVEF in the non-hyperthyrod heart disease group were statistically different （P〈 0. 05）; the LAd, LVEDd, E, A and E/A in the hyperthyrod heart disease group were statistically different （P〈 0.05） ;Vs and Va in in the non-hyperthyrod heart disease group were significantly increased while Vs/Va was significantly deereased （P〈0.01）. In the hyperthyrod heart disease group, Vs, Va and Vs/Va were all decreased （P〈0.01）. Conclusions： QTVI is an effective tool to evaluate the heart damage caused by hyperthyroidism. Ve/Va is a sensitive parameter in evaluating the early cardiac diastolic dysfunction and Vs is sensitive to detect cardiac systolic dysfunction due to hyperthyroidis.
出处
《海南医学院学报》
CAS
2013年第7期915-918,923,共5页
Journal of Hainan Medical University
基金
中国高校医学期刊临床专项资金项目(112210706)~~
关键词
定量组织速度成像
甲状腺功能亢进
甲亢性心脏病
左心室功能
Quantitative tissue velocity imaging
Hyperthyroidism
Hyperthyrod heart disease
Left ventricular function
