应变率成像技术对甲状腺功能亢进症患者左室功能的评价

目的探讨应变率成像技术（SRI）对甲状腺功能亢进症（简称甲亢）患者左室功能的评价。方法将临床确诊的65例甲亢患者根据临床表现和辅助检查分为单纯甲亢组（34例）和甲亢性心脏病（甲亢心）组（31例），进行超声心动图检查，在心尖两腔、三腔和四腔切面获得左室各节段的应变率曲线，计算左室平均峰值应变率，并与对照组（35例）进行比较分析。结果与对照组比较，收缩功能指标中仅甲亢心组收缩期最大应变率有明显降低（1．39±0．24）s-1比（1．56±0．27）s-1]，差异有统计学意义（P〈0．05）；单纯甲亢组及甲亢心组的舒张功能指标舒张早期最大应变率分别为（1．72±0．26）、（1．51±0．28）s-1比（1．96±0．31）s-1]、舒张晚期最大应变率分别为（1．59±0．30）、（1．46±0．27）s-1比（1．73±O．33）s。]均显著降低，差异有统计学意义（P〈0．05）。结论甲亢患者早期即有舒张功能改变；收缩功能的改变晚于舒张功能的改变。SRI能早期检测甲亢患者的左室收缩功能和舒张功能的异常。

Evaluation of left ventricular function in patients with hyperthyroid by strain rate imaging

Objective To explore the clinical value of strain rate imaging（SRI） in assessing the left ventricular function in patients with hyperthyroid. Methods The 65 patients with hyperthyroid were divided into two groups by clinical symptoms：simple hyperthyroid （34 cases） and hyperthyroid heart disease （31 cases）; and they were tested using ultrasonic cardiogram. Systole strain rate （SRs）, early diastolic strain rate （SRe）, late diastolic strain rate （SRa） at left ventricular segments of two-chamber, three-chamber and four- chamber views were measured using SRI, and compared with that in healthy subjects （35 cases）. Results Compared with that in healthy subjects, SRs in hyperthyroid heart disease was obviously lower （ 1.39 ± 0.24） s-1 vs （1.56 ± 0.27 ） s-1, P 〈 0.05 ], SRe and SRa was significantly lower in simple hyperthyroid and hyperthyroid heart disease （ 1.72 ± 0.26）, （ 1.51 ± 0.28 ）s-1 vs （ 1.96 ± 0.31 ）s-1 and （ 1.59 ± 0.30）, （ 1.46 ± 0.27）s-1 vs （1.73 ±0.33）s-l,P 〈0.05]. Conclusions Left ventricular function in early patients with hyperthyroid is decreased; and the change of systolic function is later than diastolic function. SRI is helpful in assessing the early left ventricular systolic and diastolic dysfunction in patients with hyperthyroid.