应用波强度技术评估甲状腺功能亢进症血流动力学的变化  

Application of wave intensity technique on assessing hemodynamic changes in hyperthyroidism

作　　者：王美玲[1] 张艳容[1] 吕清[1] 谢明星[1] 尹烨华[1] 鲁成发[1] 严天慰[1] 黄艳[1] 项飞翔[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声科湖北省分子影像中心重点实验室,武汉430022

出　　处：《中华超声影像学杂志》2009年第8期675-679,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨波强度（wave intensity，WI）技术评估甲状腺功能亢进症（甲亢）患者血流动力学改变的临床意义。方法应用WI技术对35例甲亢患者及32例正常人的右侧颈总动脉进行检测，获得WI各参数，将两组各参数进行比较。结果①甲亢组收缩早期峰值（W1）和收缩晚期峰值（W2）均显著高于对照组[W1：（24．94±15．45）×10^3mmHg·m^-1·s^-3对（9．70±4．88）×10^3mmHg·m^-1·s^-3，P〈0．001，1mmHg=0．133kPa；W2：（3．33±1．82）10^3mmHg·m^-1·s^-3对（2．10±1．24）10^3mmHg·m^-1·s^-3，P=0．003]；②甲亢组心电图R波到W1的时间间隔（R-1st）和W1到W2的时间间隔（1st2nd）均低于对照组，两组的R-1st分别为（79．49±14．64）ms、（104．47±11．52）ms，1st-2nd分别为（226．37±26．33）ms、（266．69±18．38）ms，差异均有统计学意义（P〈0．001）；③两组收缩中期负向波面积（NA）、血管僵硬度（β）、血管顺应性（AC）、脉搏波传导速度（PWVβ和PWVw1）差异均无统计学意义；④11例甲亢患者的WI曲线于收缩中期在基线上下出现异常波动。结论WI技术能够反映甲亢患者心血管的改变，部分甲亢患者射血中期出现血流动力学紊乱。Objective To investigate the value of wave intensity （WI） technique in assessing hemodynamic alteration of hyperthyroid patients. Methods Thirty five hyperthyroid patients and 32 healthy people were examined with high frequency ultrasonography. Right common carotid artery （RCCA） was targeted for ultrasonic imaging to obtain WI parameters which were automatically calculated by WI software. WI parameters include amplitude of the peak during early systole （W1）, amplitude of the peak during late systole （W2）,area of the negative wave during mid systole （NA）, interval between R wave of electrocardiogram and W1 （R-1st）, interval between W1 and W2 （ 1st -2nd）, arterial stiffness （13）, arterial compliance（AC） and pulse wave velocity including PWVβ and PWVw1. Results （1）Both W1 and W2 of hyperthyroid group were significantly higher than those of the control group [W1：（24.94 ± 15.45） 10^3mmHg·m^-1·s^-3 vs （9.70±4.88） 10^3mmHg·m^-1·s^-3, p 〈0.001,1 mm Hg=0.133 kPa;W2： （3.33±1.82）10^3mmHg·m^-1·s^-3 vs （2.10 ± 1.24） 10^3mmHg·m^-1·s^-3, p =0.003]. （2）Both R-lst and 1st 2nd of hyperthyroid group were lower compared with the control group and both comparisons had statistically significant differences [R-1st： （79.49 ± 14.64）ms vs （104.47 ± 11.52）ms, P 〈0.001 ; 1st - 2nd：（226.37 ± 26.33）ms vs （266.69 ± 18.38）ms, P 〈0. 001]. （3）There was no significant difference in NA,β,AC, PWVβ and PWVw1 between two groups. （5）Of 35 hyperthyroid patients, 11 presented several abnormal waves on WI curves during mid-systole. Conclusions WI parameters reflect both cardiac and vascular changes of hyperthyroid patients. Mid-systolic hemodynamic turbulence appears in a portion of hyperthyroid patients.

关 键 词：超声检查 甲状腺功能亢进症 血液动力学现象 波强度 

分 类 号：R686[医药卫生—骨科学]