超声二维应变成像评价甲状腺功能亢进患者右室舒张功能

摘要

Objective To evaluate right ventricular(RV)diastolic function in patients with hyperthyroid by ultrasound two-dimensional strain(2DS). Methods Forty-three patients with hyperthyroid and 33 healthy controls were included in this study. RV end-diastolic dimension(RVED) , RV ejection fractions(RVEF) , RV percent change in area(RVPCA) and tricuspid inflow velocity Etv,Atv,and E/Atv ratio were measured. Two-dimensional images were obtained at the apical four-chamber views and then analyzed offline by using automated software(EchoPAC,GE Medical). The myocardial longitudinal peak diastolic stain rate was determined at the basal, mid, and apical segment of the RV free wall by 2DS,and RV global longitudinal peak diastolic stain rate was also determined by 2DS. The data were compared between the two groups. Results The RVED, RVEF, RVPCA and tricuspid inflow velocity Etv, Atv,E/Atv ratio had no significant difference between the two groups(PX). 05). For the 2DS results, the Sre and Sre/Sra ratio in all the segments of the RV free wall had no significant difference between the two groupsCP X). 05) ,but Sra had significant difference between the two groups(P<0. 05). Compared to the controls,the Sre of RV globe was lower in patients with hyperthyroid(P>0. 05) ,but the Sra was higher,and the Sre/Sra ratio was lower(P<0. 05). Conclusion 2DS could accurately and quantitatively assess the longitudinal diastolic function of RV, which has a greater predictive value and more superiority than conventional echocardiography and could also provide an effective method for clinical evaluation of RV function.%目的 应用超声二维应变成像技术评价甲状腺功能亢进患者右室舒张功能.方法 选取单纯性甲亢患者43例,正常对照组33例,常规超声心动图测量右室舒张末横径(RVED)、右室射血分数(RVEF)、右室面积变化率(RVPCA)及三尖瓣口舒张期血流频谱E峰、A峰及E/A值.经胸采集并存储3个心动周期标准心尖四腔二维图像,运用EchoPAC超声工作站进行脱机分析,在二维应变的模式下,测量右室游离壁基底段、中间段、心尖段3个节段和右室整体的纵向舒张早、晚期峰值应变率(SRe、SRa),并比较各舒张期峰值应变率在两组间有无差异.结果 常规超声心动图测量的RVED、RVEF、RVPCA及三尖瓣口舒张期血流频谱E峰、A峰及E/A值在两组间差异并无统计学意义(P＞0.05).二维应变成像结果 显示,单纯性甲亢组右室游离壁各节段SRe、SRe/SRa比值与对照组比较,其差异无统计学意义(P＞0.05),而各节段SRa与正常对照组比较,其差异有统计学意义(P＜0.05).单纯性甲亢组右室整体SRe较对照组减低,但差异无统计学意义(P＞0.05),SRa较对照组增高,SRe/SRa比值较对照组减低,其差异均有统计学意义(均P＜0.05).结论 甲状腺功能亢进患者右室舒张功能受损,超声二维应变成像技术能够定量评价右室长轴舒张功能,其敏感性和准确性高于常规超声,为临床评价右心功能提供了又一有效方法.