摘要
目的:分析二维超声斑点追踪成像(2D-STI)及三维斑点追踪成像(RT-3DE)对甲状腺功能亢进患者左心室纵向收缩功能及同步性评价的价值。方法:选择2018年7月至2019年8月在诸暨市第二人民医院初次确诊为甲状腺功能亢进(甲亢)的患者93例为甲亢组,同时选择同期在该院体检中心进行健康体检的健康志愿者93例为对照组,均行2D-STI和RT-3DE检查,获得两组左心室纵向收缩功能参数及同步性参数,并对比其差异。结果:两组常规超声检查左心房内径(LAD)、左心室收缩末期内径(LVEDS)、左心室舒张末期内径(LVEDD)及室间隔厚度(IVST)及左心室射血分数(LVEF)等参数差异均无统计学意义(均P>0.05);2D-STI示甲亢组患者左心室多个节段纵向收缩峰值均显著较对照组提前[后壁基底段:(15.27±3.21)%比(20.38±4.19)%,t=9.336,P<0.001;侧壁基底段:(16.54±4.68)%比(21.26±5.65)%,t=6.204,P<0.001;前间隔基底段:(12.84±5.26)%比(18.43±6.06)%,t=6.718,P<0.001;后壁中间段:(16.44±5.13)%比(22.75±6.06)%,t=7.664,P<0.001;前间隔中间段:(12.03±4.41)%比(19.25±5.16)%,t=10.257,P<0.001;下壁心尖段:(14.36±5.06)%比(21.46±6.28)%,t=8.489,P<0.001;心尖帽:(9.43±5.28)%比(12.35±6.43)%,t=3.384,P<0.001];甲亢组2D-STI同步性参数Tls-16-SD较对照组显著延长[(82.45±15.25)%比(52.45±10.65)%,t=15.553,P<0.001]。RT-3DE示甲亢组患者左心室多个节段纵向收缩峰值均显著低于对照组[前壁基底段:(11.48±5.33)%比(19.17±6.49)%,t=8.830,P<0.001;侧壁基底段:(15.62±3.77)%比(22.08±4.56)%,t=10.529,P<0.001;下壁中间段:(15.65±3.37)%比(18.39±4.25)%,t=4.871,P<0.001;后间隔中间段:(14.39±5.36)%比(19.62±3.38)%,t=7.959,P<0.001;前壁心尖段:(11.17±5.54)%比(18.29±6.24)%,t=8.228,P<0.001;室间隔心尖段:(14.67±5.38)%比(20.53±4.34)%,t=8.175,P<0.001];甲亢组RT-3DE同步性参数Tmsv-16-SD较对照组显著延长[(84.36±16.08)%比(55.27±11.17)%,t=14.328,P<0.001]。结论:2D-STI及RT-3DE可客观评价早期甲亢患者左心室纵向收缩功能及同步性。
Objective:To explore the clinical value of 2D-STI and RT-3DE in evaluation of left ventricular longitudinal systolic function and synchrony in hyperthyroidism patients.Methods:From July 2018 to August 2019,93 patients with hyperthyroidism were selected as hyperthyroidism group,and 93 healthy volunteers were selected as control group at the same time.2D-STI and RT-3DE were performed to obtain the parameters of left ventricular longitudinal systolic function and synchrony,and the differences between the two groups were compared.Results:There were no statistically significant differences in left atrial diameter(LAD),left ventricular end systolic diameter(LVEDS),diastolic diameter of left ventricle(LVEDD),interventricular septum thickness(IVST)and left ventricular ejection fraction(LVEF)between the two groups(all P>0.05).2D-STI showed that the longitudinal systolic peak of multiple segments of left ventricle in the hyperthyroidism group was significantly earlier than that in the control group[posterior basal segment:(15.27±3.21)%vs.(20.38±4.19)%,t=9.336,P<0.001;lateral basal segment:(16.54±4.68)%vs.(21.26±5.65)%,t=6.204,P<0.001;anterior septal basal segment:(12.84±5.26)%vs.(18.43±6.06)%,t=6.718,P<0.001;posterior middle segment:(16.44±5.13)%vs.(22.75±6.06)%,t=7.664,P<0.001;middle anterior septum:(12.03±4.41)%vs.(19.25±5.16)%,t=10.257,P<0.001;apical inferior wall:(14.36±5.06)%vs.(21.46±6.28)%,t=8.489,P<0.001;apical cap:(9.43±5.28)%vs.(12.35±6.43)%,t=3.384,P<0.001].Compared with the control group,the 2D-STI synchronization parameter Tls-16-SD of the hyperthyroidism group was significantly longer[(82.45±15.25)%,(52.45±10.65)%,t=15.553,P<0.001].RT-3DE showed that the peak longitudinal contraction of multiple segments of left ventricle in hyperthyroidism group was significantly lower than that in the control group[front wall basal segment:(11.48±5.33)%vs.(19.17±6.49)%,t=8.830,P<0.001;side wall basal segment:(15.62±3.77)%vs.(22.08±4.56)%,t=10.529,P<0.001;the middle section of the bottom wall:(15.65±3.37)%vs.(18.39±4.25)%,t=4.871,P<0.001;the middle section of the posterior interval:(14.39±5.36)%vs.(19.62±3.38)%,t=7.959,P<0.001;the apex of the front wall segment:(11.17±5.54)%vs.(18.29±6.24)%,t=8.228,P<0.001;apical segment of ventricular septum:(14.67±5.38)%vs.(20.53±4.34)%,t=8.175,P<0.001].RT-3DE synchronization parameter Tmsv-16-SD in the hyperthyroidism group was significantly longer than that in the control group[(84.36±16.08)%,(55.27±11.17)%,t=14.328,P<0.001].Conclusion:2D-STI and RT-3DE can objectively evaluate left ventricular longitudinal systolic function and synchrony in patients with early hyperthyroidism.
作者
黄益芳
Huang Yifang(Department of Color Ultrasound,the Second People's Hospital of Zhuji,Zhuji,Zhejiang 311811,China)
出处
《中国基层医药》
CAS
2020年第19期2323-2328,共6页
Chinese Journal of Primary Medicine and Pharmacy
