左室压力-应变环技术用于评估甲亢患者早期心肌功能变化的临床观察  

Clinical effectiveness observation of left ventricular pressure strain loop technique for evaluating early changes in myocardial function among patients with hyperthyroidism

作　　者：罗琴音[1] 陶斌文 甘丽 黄丽珠 LUO Qinyin;TAO Binwen;GAN Li;HUANG Lizhu(Department of Ultrasound,Baise People's Hospital,Baise,Guangxi 533000,China)

机构地区：[1]百色市人民医院超声科,广西百色533000

出　　处：《中华全科医学》2024年第4期642-645,共4页Chinese Journal of General Practice

基　　金：广西壮族自治区卫生健康委2021年度西医类别自筹经费科研项目(20211735)。

摘　　要：目的为实现甲亢性心脏病的早期评估及干预,提高甲亢患者整体预后水平,探讨应用左室压力-应变环(LVPSL)技术监测甲亢患者早期心肌功能变化的效果。方法采用回顾性研究方式,以2021年1月—2023年8月百色市人民医院收治的100例甲亢患者和同期100例健康受试者为研究对象,所有研究对象均进行常规超声心动图检查和LVPSL分析。比较甲亢患者与健康受试者常规超声心动图指标及LVPSL指标的差异,分析甲亢患者LVPSL指标与血清甲状腺激素含量的相关性。结果甲亢患者左心房前后径(LAD)、左室舒张末期后壁厚度(LVPWT)、室间隔舒张末期厚度(IVST)、左心室舒张末期前后径(LVEDD)、左心室收缩末期前后径(LVESD)和左心室射血分数(LVEF)等常规超声心动图指标与健康受试者差异均无统计学意义(P>0.05)。甲亢患者整体纵向应变(GLS)绝对值、整体做功指数(GWI)、整体有效功(GCW)和整体做功效率(GWE)均显著低于健康受试者,而整体无效功(GWW)显著高于健康受试者(P<0.001)。GLS(绝对值)、GWI、GCW和GWE与血清FT3、FT4水平均呈负相关关系(P<0.001),而与血清TSH水平均呈正相关关系(P<0.001);GWW与血清FT3、FT4水平均呈正相关关系(r=0.526、0.547,P<0.001),而与血清TSH水平呈负相关关系(r=-0.641,P<0.001)。结论LVPSL技术可识别常规超声心动图检查无法识别的甲亢患者早期心肌功能变化,可以早期评估甲亢患者心肌损伤情况。Objective The objective is to enable early assessment and intervention of hyperthyroidism heart disease,improve the overall prognosis of hyperthyroidism patients,and explore the clinical effectiveness of utilizing left ventricular pressure strain loop(LVPSL)technology for monitoring early changes in myocardial function among hyperthyroidism patients.Methods A retrospective study was conducted at Baise People's Hospital from January 2021 to August 2023.A total of 100 patients with hyperthyroidism and 100 healthy subjects were selected as research participants.All subjects underwent routine echocardiography and LVPSL analysis.The study compared the differences in conventional echocardiographic and LVPSL indicators between hyperthyroidism patients and healthy subjects,and analyzed the correlation between LVPSL indicator values and serum thyroid hormone levels in hyperthyroidism patients.Results There was no statistically significant differences in conventional echocardiography indicators such as LAD,LVPWT,IVST,LVEDD,LVESD,and LVEF between patients with hyperthyroidism and the control group(P>0.05).However,hyperthyroidism patients exhibited significantly lower values of GLS(absolute value),GWI,GCW,and GWE compared to healthy subjects,while the GWW detection value was significantly higher(P<0.001).Furthermore,GLS(absolute value),GWI,GCW,and GWE showed negative correlations with serum FT3 and FT4 levels(P<0.001),but positive corrections with serum TSH levels(P<0.001).On the other hand,GWW demonstrated positive correlations with serum FT3 and FT4 levels(r=0.526,0.547;P<0.001),while showing a negative correlation with serum TSH levels(r=-0.641,P<0.001).Conclusion LVPSL technology can effectively identify early myocardial functional changes in hyperthyroidism patients that are not detectable through conventional echocardiography.It serves as a valuable tool for evaluating myocardial injury in hyperthyroidism patients and predicting the onset of early hyperthyroidism heart disease.

关 键 词：左室压力-应变环 超声心动图 甲状腺功能亢进症 心肌功能 早期预测 

分 类 号：R581.1[医药卫生—内分泌] R540.45[医药卫生—内科学]