二维超声心动图评价甲状腺机能亢进患者右心功能

RIGHT VENTRICULAR FUNCTION IN PATIENTS WITH HYPERTHYROIDISM BY TWODIMENSIONAL ECHOCARDIOGRAPHY

目的：研究甲状腺机能亢进患者的右心功能改变及甲状腺大部切除术对其的影响。方法：采用二维超声心动图对４７例甲状腺机能亢进患者的右心功能进行了研究，并与５０例正常受试者进行了对比。右室容积采用单平面面积－长度法计算。结果：与正常受试者相比，甲状腺机能亢进患者的右室射血分数及右室每搏容积增加（患者：５９．９９％±５．８６％，９７．８０±２０．８３ｍｌ；正常对照：５５．１６％±６．８９％，８７．６２±２０．２９ｍｌ，Ｐ均＜０．０５），右室收缩末期容积减小（患者：６６．６６±２１．７６ｍｌ，正常对照：７１．９７±２０．７９ｍｌ，Ｐ＜０．０５）。在进行了甲状腺次全切除的１７例患者中，手术后右室每搏容积及射血分数较术前下降，右室收缩末期容积增加。但无论与正常受试者相比或手术前后相比，右室舒张末期容积均无显著改变。另外，甲状腺机能亢进患者的右心功能指标与血浆甲状腺素无线性相关关系。结论：甲状腺机能亢进患者的右心功能亢进，而且手术治疗后可以恢复。

Objective:To evaluate changes of right ventricular function in patients with hyperthyroidism and the effects of subtotal thyroidectomy.Methods:Right ventricular function was studied in 47 patients with hyperthyroidism and 50 normal controls with two dimensional echocardiography.Right ventricular volumes were determined by singleplane arealength method.Results:Right ventricular ejection fraction(RVEF) and stroke volume(RVSV) were increased and right ventricular endsystolic volume(RVESV) decreased in patients with hyperthyroidism(59.99%±5.86%,97.80±20.83ml,66.66±21.76ml,respectively) than in controls(55.16%±6.89%,87.62±20.29ml,71.97±20.79ml,respectively.All P<0.05).In the 17 patients who underwent subtotal thyroidectomy,RVEF and RVSV decreased and RVESV increased after operation.However,right ventricular enddiastolic volume showed no significant difference between patients with hyperthyroidism and the controls,and no change before and after operation.There were no linear relationships between RVEF and right ventricular volumes and the level of serum thyroxin.Conclusion:Right ventricular function in patients with hyperthyroidism was increased,and back to normal after operation.