超声二维应变成像技术在评价甲状腺功能亢进患者右室纵向收缩功能中的运用

Ultrasound two-dimensional strain evaluates right ventricular logitudinal systolic function in patients with hyperthyroid

目的:应用超声二维应变成像技术评价甲状腺功能亢进(甲亢)患者右室纵向收缩功能。方法:根据甲亢的临床症状和相关辅助检查分为单纯性甲亢组(43例)和甲亢性心脏病组(20例),正常对照组33例。经胸采集并存贮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,测量右室游离壁和室间隔右室面基底段、中间段及心尖段6个节段的纵向收缩期峰值应变和右室整体收缩峰值应变值,并比较各收缩期峰值应变在3组间的差异。同时测量并分析右室舒张末横径(RVED)、右室射血分数(RVEF)、右室面积变化率(RVPCA)及三尖瓣环收缩期峰值速度(TVSPV)等指标与右室整体收缩峰值应变的相关性。结果:甲亢性心脏病组右室游离壁及室间隔基底段、中间段、心尖段及右室整体的收缩期峰值应变较正常对照组和单纯性甲亢组均显著减低,差异具有统计学意义(P<0.001);单纯性甲亢组右室游离壁及室间隔基底段、中间段、心尖段及右室整体的收缩期峰值应变较正常对照组稍减低,但差异无统计学意义(P>0.05);RVED、RVEF、RVPCA及TVSPV与右室整体收缩期峰值应变均具有良好的相关性(r分别为=-0.355、0.351、0.398和0.292,均P<0.01)。结论:超声二维应变成像技术能够准确定量评价甲亢患者右室长轴收缩功能,为临床评价右心功能提供了又一有效方法。

Objective：To evaluate right ventricular（RV） logitudinal systolic function in patients with hyperthyroid using ultrasound two-dimensional strain（2DS）.Method：According to the clinical features and assistant examinations,the patients with hyperthyroid were divided into two groups：simple hyperthyroid（43 cases） and hyperthyroid heart disease groups（20 cases）,and 33 healthy controls were included in this study.Two-dimensional images were obtained at the apical four-chamber views and then were analyzed offline by using automated software（EchoPAC,GE Medical）.The myocardial logitudinal peak systolic stain were determined at the basal,mid,and apical segment of the RV free wall and ventricular septum by 2DS,RV global logitudinal peak systolic stain were also determined by 2DS.The data in three groups were compared.Besides,RV end-diastolic dimension（RVED）,RV ejection fractions（RVEF）,RV percent change in area（RVPCA） and tricuspid annular systolic peak velocity（TVSPV） were measured,and correlation of these parameters with RV global logitudinal peak systolic stain was analyzed.Result：Logitudinal peak systolic strain of RV globe and free wall for all segments were obviously lower in patients with hyperthyroid heart disease than those with simple hyperthyroid and controls（P0.001）.Compared to the controls,the logitudinal peak systolic strain of RV globe and free wall for all segments in patients with simple hyperthyroid were little lower（P0.05）.RVED、RVEF、RVPCA and TVSPV were closely correlated with the logitudinal peak systolic strain of RV globe in patients with hyperthyroid.Conclusion：2DS could assess the logitudinal systolic function of RV accurately and quantitatively,which provides an effective method for clinical evaluation of RV function.