超声心动图诊断甲减性机能减退性心脏病的价值研究

Study on the Value of Echocardiography in Diagnosis of Hypothyroid Cardiopathy

目的总结和探讨超声心动图在诊断甲减性机能减退性心脏病中的临床价值。方法对确诊为甲减性机能减退性心脏病的46例患者与32例正常人行超声心动图检查,并进行对照分析。结果 48例甲减性机能减退性心脏病除一般临床表现外,二维超声心动图均表现为心肌壁增厚,心肌内不规则点状回声,室壁运动普遍减低,合并心包积液30例(占62.5%)。M超表现为室壁增厚率(ΔT%),左室短轴缩短率(ΔD%)和射血分数(EF)降低,与对照组相比有显著差异性(P<0.05)。多普勒超声心动图上表现为各瓣口血流加速度降低,峰值流速降低,心动周期时相上射血时间(ET)无明显改变,射血前期时间(PEP)延长,PEP/ET比值明显增加,与对照组相比有显著差异性(P<0.01),提示收缩与舒张功能不良。结论甲减性机能减退性心脏病起病隐匿,临床表现复杂,超声心动图对其的诊断与鉴别诊断有重要意义。

Objective To summarize and study the clinical significance of echocardiography in diagnosing hypothyroid cardiopathy. Methods 48 patients with hypothyroidism and 40 healthy people were evaluated by standard echocardiography. Results Including general clinical manifestations, 48 patients with hypothyroidism heart disease showed myocardial wall thickening, irregular point- like echoes in the myocardium, generally reduction of wall motion and pericardial effusion（30 cases, 62.5%）evaluated by two dimensional ultrasonic. Compared to healthy people, patients with hypothyroidism heart disease had lower wall thickness ratio（AT%）（P〈0.05）, left ventricular minor axis decurtaion rate（AD%）（P〈0.05）and ejection fraction（EF）（P〈0.05%）. The blood flow acceleration and peak velocity of transvalvular flow decreased, and the ejection time had no significant change during cardiac cycle. Pre-ejection phase prolonged, and PEP/ET ratio had a significant increase, evaluated by M-mode ultrasound, there is significant difference between the two groups （P〈0.01）, suggesting systolic and diastolic dysfunction. Conclusion Hypothyroidism heart disease represents insidiously and the clinical manifestations are complex. Echocardiographic is important for the diagnosis of hypothyroidism heart disease.