超声心动图对甲状腺功能亢进性心脏病的诊断价值

The clinical value of echocardiography in the diagnosis of hyperthyroid heart disease

目的 :探讨超声心动图对甲状腺功能亢进性心脏病(甲亢心)的诊断价值。方法 :选择行超声心动图检查的甲状腺功能亢进(甲亢)患者80例,其中单纯甲状腺功能亢进43例,为单纯甲亢组;合并甲亢心37例,为甲亢心组;选择正常健康志愿者40例,列为对照组,比较3组超声心动图检查结果。结果:1甲亢心组A/E、右室舒张末期内径(RVDd)、左室舒张末期内径(LVDd)高于单纯甲亢组与对照组,E峰、舒张末期左室后壁厚度(LVPWd)、左室射血分数(LVEF)、肺动脉瓣前向血流速度(Poflow)、主动脉瓣前向血流速度(Aoflow)低于单纯甲亢组及对照组,A峰高于对照组,差异均有统计学意义(均P<0.05),单纯甲亢组A峰、E峰、LVEF及A/E高于对照组,差异均有统计学意义(均P<0.05)。2甲亢心组左心房增大、右心房增大、左心室增大、右心室增大、左室壁增厚、左室壁变薄、左室壁运动减弱、左室收缩功能降低、左室舒张功能降低发生率分别为75.68%、21.62%、43.24%、54.05%、32.43%、16.22%、27.03%、18.92%、27.03%,左心房、右心室增大发生率最高。3甲亢心组二尖瓣反流26例,占70.27%,三尖瓣反流23例,占62.16%;肺动脉扩张25例,占67.57%;二尖瓣脱垂4例,占10.81%;主动脉瓣反流2例,占5.41%。结论:超声心动图在观察心脏形态、检测心脏功能方面具有较高实用价值,可作为评估甲亢心病情的常规检查方法。

Objective：To explore the clinical value of echocardiography in the diagnosis of hyperthyroid heart disease. Method：Selected 80 cases hyperthyroidism patients who accepted echocardiography examination,43 patients with hyperthyroidism among them were as the hyperthyroidism group,37 patients with hyperthyroidism heart disease were as the hyperthyroidism heart group,40 healthy volunteers were chosen as the control group,three groups were compared echocardiographie examine result. Result：（1）A/E,LVEDd,LVDd higher,E peak,LVPWd,LVEF,Poflow,Aofiow were lower in hyperthyroid heart group than those of hyperthyroidism group and control group;A peak was higher than that of the control group,the difference was statistically significant （P〈0.05）. A peak,E peak,LVEF and A/E of simple hyperthyroidism group were higher than those of the control group, the difference was statistically significant （P〈0.05）;（2）In observation group,left atrial enlargement,fight atrial enlargement,left ventricle increases,fight ventricle,left ventricular wall thickening,left ventricular wall thinning,decreased left ventricular wall motion,left ventricular systolic function,left ventrieular diastolic function to reduce the occurrence rates were 75.68% ,21.62%, 43.24%,54.05%,32.43%, 16.22%,27.03%, 18.92%,27.03%,respectively;left atrium,right ventricle increased the highest incidence; （3）In the observation group,26 cases of mitral regurgitation,accounting for 70.27% ,23 cases of tricuspid regurgitation,accounting for 62.16%,25 cases of pulmonary expansion,accounting for 67.57%;4 cases of mitral valve prolapse,accounting for 10.81%,2 cases of aortic regurgitation,accounting for 5.41%. Conclusion：Echocardiography observe cardiac morphology,detect of cardiac function has high practical value,can be used as a routine examination to assess heart disease hyperthyroidism.