摘要
目的探讨结节性甲亢和结节性甲肿的血流频谱特征和血流参数变化的规律。方法应用彩色多普勒超声诊断仪观察结节性甲亢患者(43例)、结节性甲肿患者(41例)和正常人(40例)的甲状腺厚度和面积,甲状腺上动脉(STA)的频谱特征以及收缩期峰值流速(PSV)、舒张期最小流速(EDV)和阻力指数(RI)。结果结节性甲亢与结节性甲肿二维超声虽有一定变化,但很难区别。正常组甲状腺厚度和面积(14.48±3.04)mm、(1.28±0.31)cm^2,结节性甲肿组(23.31±4.34)mm、(2.59±0.57)cm^2,结节性甲亢组(22.65±5.05)mm、(2.63±0.61)cm^2;与正常组比较,结节性甲肿组和结节性甲亢组差异均有统计学意义(均P<0.01),但这两组之间差异无统计学意义(均P>0.05)。与结节性甲肿不同之处,结节性甲亢的频谱特征为第一峰高尖,第二峰低缓,甚至有两峰融合,峰时延长、后移。正常组STA的内径、平均流速和血流量(0.13±0.02)cm、(21.35±8.89)cm/s、(15.03±7.24)ml/min,结节性甲肿组(0.19±0.03)cm、(39.53±20.38)cm/s、(70.78±30.78)ml/min,结节性甲亢组(0.24±0.05)cm、(57.67±25.46)cm/s、(105.11±35.28)ml/min;与正常组比较,结节性甲肿组和结节性甲亢组差异均有统计学意义(均P<0.01),两两比较,结节性甲肿组和结节性甲亢组之间差异亦有统计学意义(均P<0.05)。正常组STA的血流动力学变化(12.43±5.70)cm/s、(6.03±2.91)cm/s、(0.51±0.08)cm/s,结节性甲肿组(15.45±7.68)cm/s、(6.41±3.44)cm/s、(0.53±0.08)cm/s,结节性甲亢组(24.33±10.15)cm/s、(6.61±5.15)cm/s、(0.60±0.09)cm/s;与正常对照组和结节性甲肿组比较,结节性甲亢组STA的PSV和RI均明显增高(P<0.05或P<0.01)。结论甲状腺STA峰值流速增快,第一峰高尖,第二峰低缓,两峰融合,峰时延长、后移以及内径增宽,流速加快,血流量增加,作为结节性甲亢的独有特征,可以鉴别结节性甲肿与结节性甲亢。
Objective To study the spectrum characteristics and changes of blood flow parameters of patients with nodular hyperthyroidism and goiter.Methods The thyroid thickness and area,as well as the peak systolic velocity(PSV),end diastolic velocity(EDV),and resistance index(RI)of superior thyroid artery(STA),in the patients with hyperthyroidism(43 cases)and nodular goiter(41 cases)and in the normal persons(40 cases)were observed by color Doppler ultrasonic diagnosis instrument.Results There were certain changes of twodimensional echocardiography in the patients with nodular hyperthyroidism and goiter,but difficult to distinguish.The thyroid thickness and area were(14.48±3.04)mm and(1.28±0.31)cm^2 in the normal group;were(23.31±4.34)mm and(2.59±0.57)cm^2 in the nodular goiter group;and were(22.65±5.05)mm and(2.63±0.61)cm^2 in the nodular hyperthyroidism group;with statistical differences between the normal group on one hand and the nodular hyperthyroidism group and the nodular goiter group on the other hand(P<0.01),but no between the nodular hyperthyroidism group and the nodular goiter group(P>0.05).Different from those of the nodular goiter group,the spectrum characteristics of the nodular hyperthyroidism group were high and sharp at the first peak,low at the second peak,and even had two peaks becoming fusion,extending,and backward.The inner diameter,average velocity,and blood flow of STA were(0.13±0.02)cm,(21.35±8.89)cm/s,and(15.03±7.24)ml/min in the normal group;were(0.19±0.03)cm,(39.53±20.38)cm/s,and(70.78±30.78)ml/min in the nodular goiter group;and were(0.24±0.05)cm,(57.67±25.46)cm/s,and(105.11±35.28)ml/min in the nodular hyperthyroidism group;with statistical differences between these 3 groups(P<0.01 or P<0.05).The PSV,EDV,and RI of STA were(12.43±5.70)cm/s,(6.03±2.91)cm/s,and(0.51±0.08)cm/s in the normal group;were(15.45±7.68)cm/s,(6.41±3.44)cm/s,and(0.53±0.08)cm/s in the nodular goiter group;and were(24.33±10.15)cm/s,(6.61±5.15)cm/s,and(0.60±0.09)cm/s in the nodular hyperthyroidism group;
作者
苟珊
贺京军
Gou Shan;He Jingjun(Physical Examination Center,Guangdong NO.2 Provincial People’s Hospital,Guangzhou 510317,China)
出处
《国际医药卫生导报》
2020年第2期170-172,176,共4页
International Medicine and Health Guidance News
基金
广东省医学科研基金项目资助(A2010125)。
关键词
结节性甲亢
彩色多普勒超声
血流动力学
血流频谱
Nodular hyperthyroidism
Color Doppler ultrasound
Hemodynamics
Blood flow spectrum
