DHM技术评价甲状腺功能亢进患者左心房容积和功能的变化  

Assessing Left Atrial Volume and Functional Dynamics in Hyperthyroidism:A Comprehensive Evaluation Utilizing

作　　者：李可越 姚驰 陈媛 葛丽丽 DHM LI Keyue;YAO Chi;CHEN Yuan;GE Lili(Department of Ultrasound,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院超声科,辽宁锦州121000

出　　处：《锦州医科大学学报》2024年第6期68-74,共7页Journal of Jinzhou Medical University

基　　金：辽宁省兴辽英才计划项目,项目编号:XLYC1802049;锦州医科大学大学生创新训练项目,项目编号:X202310160054。

摘　　要：目的探讨三维动态心脏模型(dynamic heart modeling,DHM)技术评价甲状腺功能亢进患者左心室收缩功能。方法选取甲状腺功能亢进患者80例,单纯甲状腺功能亢进42例,合并甲状腺功能亢进性心脏病(hyperthyroid heart disease,HHD)38例,同期选取健康体检者40例作为对照组。测定所有研究对象的一般临床资料参数、常规心脏超声参数与DHM技术参数,比较各组间参数的差异,并探讨参数之间的相关性以及HHD的危险因素和诊断效能。结果(1)与对照组比较,甲状腺功能亢进组、HHD组FT3、FT4、心率、收缩压均增加,TSH降低(P<0.05);(2)与对照组比较,甲状腺功能亢进组二尖瓣舒张晚期血流峰值速度(A)及E/e′均增大,e′及心室舒张早期快速充盈的充盈峰/舒张晚期(心房收缩)充盈的充盈峰(E/A)均减小(P<0.05);HHD组左房前后径(left atrial diameter,LAD)、A、E/e、左心室舒张末期内径(left ventricular end diastolic dimension,LVEDD)均增大(P<0.05),e′、E/A及左心室射血分数(left ventricular ejection fraction,LVEF)均减小(P<0.05);与甲状腺功能亢进组相比,HHD组LVEF减小(P<0.05);(3)与对照组相比,甲状腺功能亢进组左心房最小容积(minimum left atrial volume,LAVmin)、左心房收缩前容积(left atrial volume before contraction,LAVpre)、左心房最大容积指数(left atrial maximum volume index,LAVImax)、左心房最小容积指数(left atrial minimum volume index,LAVImin)、左心房收缩前容积(left atrial pre-contractile volume index,LAVIpre)、左心房主动排空分数(left atrial passive emptying fraction,LAAEF)均增大(P<0.05),左心房被动排空分数(left atrial active emptying fraction,LAPEF)减小(P<0.05);HHD组LAVmax、LAVmin、LAVpre、LAVImax、LAVImin、LAVIpre、LAAEF均增大(P<0.05),LAEF、LAPEF均减小(P<0.05);与甲状腺功能亢进组比较,HHD组LAVmax、LAVmin、LAVpre、LAVImax、LAVImin、LAVIpre均增大(P<0.05),LAEF、LAAEF、LAPEF均减小(P<0.05)。结论DHM技术可识�Objective To explore the three-dimensional dynamic heart modeling(DHM)technology to evaluate the left ventricular systolic function in patients with hyperthyroidism.Methods A total of 80 patients with hyperthyroidism were selected,including 42 patients with simple hyperthyroidism and 38 patients with hyperthyroidism.During the same period,40 healthy subjects were selected as the control group.The general clinical data parameters,conventional cardiac ultrasound parameters and DHM technical parameters of all subjects were measured,and the differences in parameters among the groups were compared.The correlation between the parameters,the risk factors and diagnostic efficacy of hyperthyroidism were also explored.Results(1)Compared with the control group,FT3,FT4,heart rate,and systolic blood pressure increased,and TSH decreased in the hyperthyroidism group and hyperthyroidism heart group(P<0.05);(2)compared with the control group,A and E/e increased,and e′and E/A decreased in the hyperthyroid group(P<0.05);LAD,A,E/e′,and LVEDd increased in the hyperthyroid heart group(P<0.05),and e′,E/A,and LVEF decreased(P<0.05);LVEF decreased in the hyperthyroid heart group compared with the hyperthyroid group(P<0.05);(3)compared with the control group,LAVmin,LAVpre,LAVImax,LAVImin,LAVIpre,and LAAEF in the hyperthyroid group were increased(P<0.05),and LAPEF was decreased(P<0.05);LAVmax,LAVmin,LAVpre,LAVImax,LAVImin,LAVIpre,and LAAEF in the hyperthyroid heart group were increased(P<0.05),and LAEF and LAPEF were decreased(P<0.05);compared with the hyperthyroid group,LAVmax,LAVmin,LAVpre,LAVImax,LAVImin,and LAVIpre in the hyperthyroid heart group were increased(P<0.05),and LAEF,LAAEF,and LAPEF were decreased(P<0.05).Conclusion The DHM technique enables the identification of left ventricular systolic dysfunction in patients with hyperthyroidism and hyperthyroid heart,making it a valuable and routine diagnostic tool for assessing the condition of the hyperthyroid heart.

关 键 词：DHM 甲状腺功能亢进性心脏病 左心房容积 左心房收缩功能 

分 类 号：R445.1[医药卫生—影像医学与核医学]