实时三维斑点追踪成像评价甲状腺功能亢进患儿左心室整体收缩功能  

Assessment of Left Ventricular Global Systolic Function Using Real-Time Three-Dimensional Speckle Tracking Imaging in Children with Hyperthyroidism

作　　者：杜程程 高磊[2] Du Chengcheng;Gao Lei(Chengde Medical University,Chengde Hebei 067000,China;Baoding No.1 Central Hospital,Baoding Hebei 071000,China)

机构地区：[1]承德医学院,河北承德067000 [2]保定市第一中心医院,河北保定071000

出　　处：《医疗装备》2022年第7期9-14,共6页Medical Equipment

摘　　要：目的应用实时三维斑点追踪成像(RT3D-STI)评价甲状腺功能亢进患儿左心室整体收缩功能。方法选择2017年1月至2019年5月于保定市第一中心医院确诊但未经治疗的甲状腺功能亢进患儿32例,设为甲状腺功能亢进组;选择同期疑诊甲状腺功能亢进但后经检查证实排除此病的儿童32例,设为对照组。两组均行常规超声心动图检查,采用RT3D-STI技术处理图像后保存相关图像,比较两组体质量指数(BMI)、心率、舒张压、收缩压及甲状腺功能指标、常规超声测量参数及RT3D-STI应变值,分析甲状腺亢进组RT3DSTI应变参数与促甲状腺激素(TSH)的相关性。结果两组BMI、舒张压及收缩压比较,差异均无统计学意义(P>0.05);甲状腺功能亢进组心率快于对照组,总三碘甲状腺原氨酸(TT_(3))、总甲状腺素(TT_(4))、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、甲状腺过氧化物酶抗体(TPOAb)、促甲状腺激素受体抗体(TRAb)及甲状腺球蛋白抗体(TgAb)水平均高于对照组,差异均有统计学意义(P<0.05);甲状腺功能亢进组TSH水平低于对照组,差异有统计学意义(P<0.05)。两组左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVEDs)、左心室射血分数(LVEF)、室间隔舒张末期厚度(IVSD)、左心室后壁舒张末期厚度(LVPWD)、左心房前后径(LA)、左心室短轴缩短率(LVFS)、每搏输出量(SV)、二尖瓣E波峰值速度及二尖瓣A波峰值速度比较,差异均无统计学意义(P>0.05);甲状腺功能亢进组左心室质量(LVM)及左心室质量指数(LVMI)均大于对照组,差异有统计学意义(P<0.05)。甲状腺功能亢进组左心室整体圆周应变(GCS)、左心室整体径向应变(GRS)、左心室整体长轴应变(GLS)及左心室整体面积应变(GAS)均低于对照组,差异有统计学意义(P<0.05)。甲状腺亢进患者的左心室GLS、GAS与TSH成正相关Objective Real-time three-dimensional speckle tracking imaging(RT3D-STI)was used to evaluate the left ventricular global systolic function in children with hyperthyroidism.Methods A total of 32 children with hyperthyroidism diagnosed but untreated in Baoding No.1 Central Hospital from January 2017 to May 2019 were selected as the hyperthyroidism group.32 children suspected with hyperthyroidism(actually not with hyperthyroidism verified by subsequent examination)during the same period were selected as the control group.Conventional echocardiography was performed in the two groups.RT3D-STI technology was used to process the images and save the relevant images.Body mass index(BMI),heart rate,diastolic blood pressure,systolic blood pressure and thyroid function indexes,conventional echocardiography parameters and RT3D-STI strain values were compared between the two groups.The correlation between RT3D-STI strain parameters and thyroid stimulating hormone(TSH)in the hyperthyroidism group was analyzed.Results There was no significant difference in BMI,diastolic blood pressure and systolic blood pressure between the two groups(P>0.05);The heart rate of the hyperthyroidism group was faster than that of the control group,and the levels of total triiodothyronine(TT_(3)),total thyroxine(TT_(4)),free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),thyroid peroxidase antibody(TPOAb),thyroid stimulating hormone receptor antibody(TRAb)and thyroglobulin antibody(TgAb)were all higher than those of the control group,the differences were statistically significant(P<0.05);The TSH level in the hyperthyroidism group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic diameter(LVEDd),left ventricular endsystolic diameter(LVEDs),left ventricular ejection fraction(LVEF),interventricular septum enddiastolic thickness(IVSD),left ventricula

关 键 词：甲状腺功能亢进 儿童 实时三维斑点追踪 应变 左心室功能 

分 类 号：R581[医药卫生—内分泌]