超声多普勒成像评价甲状腺功能亢进性心脏病右室心功能

摘要

目的 应用超声脉冲多普勒(PW)、组织多普勒成像(TDI)联合技术评价甲状腺功能亢进性心脏病(甲亢心)右室心功能.方法 选取60例甲亢患者,根据是否并发甲亢心(本研究只选取心脏结构正常的房性心律失常患者)分为单纯甲亢组(37例)和甲亢心组(23例),并选取30例正常人为对照组.应用PW测量三尖瓣口舒张期峰值血流速度E峰;应用TDI于心尖四腔切面三尖瓣环间隔处和侧壁处测量收缩期峰值速度(Sm)、舒张期峰值速度(Em),并计算E/Em.结果 (1)与对照组比较,单纯甲亢组侧壁处Sm增高,两组之间差异有统计学意义(P<0.05).甲亢心组侧壁处Sm较单纯甲亢组差异有统计学意义(P<0.05);(2)甲亢心组侧壁处Em减低,较对照组差异有统计学意义(P<0.05);(3)单纯甲亢组侧壁处E/Em与对照组之间差异无统计学意义(P>0.05),而甲亢心组较对照组E/Em明显增高,两组之间差异有统计学意义(P<0.05).结论 PW与TDI联合应用可以较为准确地评价甲亢心患者右室心功能.%Objective To evaluate the right ventricular function of hyperthyroid heart disease by Pulse wave (PW) and tissue Doppler imaging(TDI). Methods Sixty patients having hyperthyroidism,with hyperthyroid heart disease(This study only chose those who had normal heart structure but had atrial tachyarrhythmia. )or without were divided into simple hyperthyroidism group(n = 37)and hyperthyroid heart disease group(n = 23). Thirty normal volunteers served as control group. Tricuspid inflow velocity(E)was measured by Doppler echocardiography. TDI-derived systolic tricuspid annular velocity(Sm), diastolic tricuspid annular velocity(Em) and the ratio of diastolic tricuspid inflow velocity to Em(E/Em)were caculated. Results ①Compared with control group, Sm was higher in simple hyperthyroidism group(P＜0.05). Compared with simple hyperthyroidism group,Sm was lower in heart disease group(P＜0. 05). ②Compared with control group,Em of tricuspid annular lateral wall was lower in hyperthyroid heart disease group(P＜0. 0S). ③The E/Em ratio in hyperthyroid heart disease group was significantly higher than that in control group(P＜0. 05),however there was no significant difference between simple hyperthyroidism group and control group (P＞0. 05). Conclusions PW and TDI can exactly evaluate right ventricular function in hyperthyroid heart disease.