三维斑点追踪成像评价亚临床甲状腺功能减退女性治疗前后左心室整体收缩功能  

Assessment of Left Ventricular Global Systolic Function Using Three-dimensional Speckle Tracking Imaging in Female Patients with Subclinical Hypothyroidism Before and After Treatment

作　　者：孙秀云[1] 孙志丹[1] 张旭 郭英男[1] 

机构地区：[1]辽宁医学院附属第一医院超声科,辽宁锦州121001 [2]锦州石化医院超声科,辽宁锦州121001

出　　处：《中国医学影像学杂志》2015年第6期444-448,共5页Chinese Journal of Medical Imaging

摘　　要：目的应用三维斑点追踪成像(3D-STI)技术评价亚临床甲状腺功能减退(SHT)女性患者行左旋甲状腺激素治疗前后左心室整体收缩功能的改变。资料与方法收集研究组32例SHT女性患者及对照组40例健康女性志愿者,研究组给予左旋甲状腺激素治疗,待甲状腺功能达到正常状态后随访1年;两组均行血生化检查、常规超声心动图检查和3D-STI检查,比较两组左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVEDs)、室间隔舒张末期厚度(IVSd)、左心室后壁舒张末期厚度(LVPWd)、左心房内径(LAD)、二尖瓣口舒张期血流频谱A峰值、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF),分析三维左心室整体纵向应变(GLS)、整体圆周应变(GCS)、整体径向应变(GRS)及整体面积应变(GAS)参数以及促甲状腺激素(TSH)水平与各参数的相关性。结果治疗前研究组IVSd、LVPWd较对照组增加(t=3.30、3.64,P<0.05),研究组治疗前二尖瓣口舒张期血流频谱E峰速度及E/A均小于对照组及研究组治疗后(t=13.55、13.85、3.19、2.93,P<0.05)。研究组治疗前左心室GLS、GCS、GRS及GAS显著低于对照组(t=8.60、11.95、9.78、5.92,P<0.05)。研究组治疗后左心室GLS、GCS、GRS及GAS均高于治疗前(t=6.91、9.41、6.46、4.31,P<0.05)。TSH水平与E/A比值、E呈负相关(r=-0.39、-0.42,P<0.05);TSH水平与GLS、GCS、GRS及GAS呈负相关(r=-0.38、-0.56、-0.33、-0.41,P<0.05)。结论利用3D-STI可以较好地评价SHT女性患者左旋甲状腺激素治疗前后左心室整体收缩功能变化。Purpose To assess the left ventricular global systolic function changes using three-dimensional speckle tracking imaging （3D-STI） in female patients with subclinical hypothyroidism （SHT） undergoing L-thyroxine treatment. Materials and Methods Thirty-eight female patients with SHT and 40 healthy female volunteers of the same age （control group） were selected, all the SHT patients received L-thyroxine therapy and were followed for 1 year after euthyroid status was achieved; all the participants underwent blood biochemical examinations, complete conventional echocardiographic and 3D-STI examinations, left ventricular end-diastolic diameter （LVEDd）, left ventricular end-systolic diameter （LVEDs）, interventricular septal depth （IVSd）, left ventricular posterior wall depth （LVPWd）, left atrial diameter （LAD）, diastolic mitral flow spectrum of A peak, left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV）, and left ventricular ejection traction （LVEF） of the two groups were compared, and the correlation of parameters of three dimensional left ventricular global longitudinal strain （GLS）, global circumferential strain （GCS）, global radial strain （GRS）, global area strain （GAS）, and thyroid stimulating hormone （TSH） with each parameter was analyzed. Results 1VSd and LVPWd in the study group were higher than those of the control group （t=3.30 and 3.64, P〈0.05）. Compared with the control group, GLS, GCS, GRS and GAS of left ventricular of SHT patients in the study group were significantly lower （t=-8.60, 11.95, 9.78 and 5.92, P〈0.05） before treatment. GLS, GCS, GRS and GAS of SHT patients improved after L-thyroxine therapy, and the difference was statistically significant （t=-6.91, 9.41, 6.46 and 4.3 1, P〈0.05）.TSH level was negatively correlated with E/A ratio and E （r=- 0.39 and - 0.42, P〈0.05）, and also negatively correlated with GLS, GCS, GRS and GAS （r =- 0.38, - 0.56, - 0.33 and - 0.41, P〈0.

关 键 词：甲状腺功能减退症 超声心动描记术 三维 斑点追踪成像 心室功能 左 心肌收缩 女(雌)性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541[医药卫生—诊断学]