甲状腺功能亢进症患者超声心动图左心室应变率与左心室Tei指数的关系

摘要

目的:探讨甲状腺功能亢进症患者超声心动图左心室应变率、左心室Tei指数变化特点及其相关性.方法:将入选的98例患者依据甲状腺功能亢进症及甲亢性心脏病诊断标准分为两组,单纯甲亢组(n=52)及甲亢性心脏病组(n=46),另随机选择49例同期健康体检者作为正常对照组.所有受试者均进行体格检查、心电图、超声心动图及实验室检查.结果:正常对照组、单纯甲亢组及甲亢性心脏病组左心室Tei指数(分别为0.35±0.09,0.47±0.09及0.54±0.10)依次显著升高,各组间差异有统计学意义(P均<0.05);正常对照组、单纯甲亢组及甲亢性心脏病组左心室基底段、中间段的舒张早期最大应变率(SRe)、舒张晚期最大应变率(SRa)及收缩期最大应变率(SRs)均依次显著降低,各组间差异有统计学意义(P均<0.05).左心室基底段、中间段的SRs与左心室Tei指数呈负相关(P<0.05),与左心室射血分数、左心室短轴缩短率呈正相关(P<0.05),左心室基底段、中间段的SRe、SRa与左心室Tei指数和左心房收缩(A)峰呈负相关(P<0.05),与舒张早期(E)峰、E/A值呈正相关(P<0.05).结论:甲亢患者在未出现心脏临床症状时,已存在局部左心室壁收缩功能及舒张功能的下降.应变率参数与左心室Tei指数显著相关性.%Objective: To explore the correlation between left ventricular strain rate and Tei index in patients with hyperthyroidism (HT) and hyperthyroid heart disease (HHD) by echocardiography.Methods: A total of 98 patients were divided into two groups according to the diagnostic criteria. HT group,n=52 and HHD group,n=46;another 49 normal subjects from regular physical examination were set up as Control group. Physical examination,ECG, echocardiography were performed and compared in all participants at different groups.Results: Tei index in Control group, HT group and HHD group were elevated accordingly (0. 35 ±0. 09 ), (0. 47 ±0. 09) and (0.54±0. 10) ,P＜0. 05 respectively. Strain rate of early diastolic (SRe) ,strain rate of atrial contraction (SRa) and strain rate of systolic (SRs) of left ventricular basic section and middle section in Control group,HT group and HHD group were reduced accordingly,P＜0. 05 respectively. SRs was negatively related with Tei index and positively related with left ventricular ejection fraction and left ventricular fractional shortening,P＜ 0. 05 respectively. SRe and SRa were negatively related with Tei index and atrial contraction peak (A peak) ,positively related with early diastolic peak (E peak) and E/A ratio,P＜ 0. 05 ,respectively.Conclusion:The systolic and diastolic function of local left ventricular wall has been descended in HT patients before they have the cardiac symptoms. The left ventricular strain rate is related to Tei index.