二维斑点追踪超声心动图评价药物治疗反应对初诊甲状腺功能亢进症患者左心功能的影响OA
Effect of therapeutic response on left ventricular function in newly diagnosed hyperthyroidism patients evaluated by two-dimensional speckle tracking echocardiography
目的 应用二维斑点追踪超声心动图(two-dimensional speckle tracking echocardiography,2D-STE)评价初诊甲状腺功能亢进症(以下简称甲亢)患者药物治疗反应对左心功能的影响.方法 选取2024年3月至2025年3月于安徽医科大学附属安庆第一人民医院初次诊断为甲亢的患者40例,按疗效将甲亢患者分为控制良好组(R组,22例)和控制不佳组(NR组,18例);另选取同期健康成年人40例为对照组(C组).应用经胸超声心动图和2D-STE分别获取各组基线和治疗6个月后的左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室舒张末期容积(left ventricular end diastolic volume,LVEDV)、室间隔厚度、左室后壁厚度、左室射血分数、二尖瓣舒张早期峰值血流速度(E)/二尖瓣环舒张早期峰值运动速度(e')、整体纵向应变(global longitudinal strain,GLS)、整体圆周应变(global circumferential strain,GCS)、室间隔整体纵向应变(interventricular septal longitudinal strain,Septal-LS)、侧壁整体纵向应变(left ventricular lateral longitudinal strain,Lateral-LS)及机械离散度(mechanical dispersion,MD),比较各组参数间的差异,分析甲状腺激素水平与心功能之间的相关性.结果 基线时R组和NR组患者的LVEDD、LVEDV、E/e'均显著高于C组(P<0.05),GLS、GCS、Septal-LS、Lateral-LS均显著低于C组(P<0.001),MD显著高于C组(P<0.001).治疗后,R组患者的GLS、GCS、Septal-LS、Lateral-LS、MD较治疗前均显著改善(P<0.01),NR组患者的GLS、GCS、Septal-LS、MD则较治疗前进一步恶化(P<0.05).相关性分析显示血清游离三碘甲腺原氨酸水平与GLS呈中等程度负相关(r=-0.582,P<0.001).结论 2D-STE可敏感评估甲亢患者左心功能变化,甲状腺功能控制良好者心功能可接近正常水平,控制不佳者心功能损害加重.
Objective The two-dimensional speckle tracking echocardiography(2D-STE)was applied to evaluate the impact of therapeutic response on left ventricular function in newly diagnosed hyperthyroidism patients.Methods Forty patients who were initially diagnosed with hyperthyroidism at Anqing First People's Hospital of Anhui Medical University from March 2024 to March 2025 were selected.The patients with hyperthyroidism were divided into well-controlled group(group R,22 cases)and poorly-controlled group(group NR,18 cases)based on their therapeutic effects.Additionally,40 healthy adults in the same period were selected as control group(group C).Trans-thoracic echocardiography and 2D-STE were used to obtain the left ventricular end diastolic diameter(LVEDD),left ventricular end diastolic volume(LVEDV),interventricular septal thickness,left ventricular posterior wall thickness,left ventricular ejection fraction,E/e',global longitudinal strain(GLS),global circumferential strain(GCS),interventricular septal longitudinal strain(Septal-LS),left ventricular lateral longitudinal strain(Lateral-LS)and mechanical dispersion(MD)at baseline and 6 months after treatment for each group.The differences among the parameters of each group were compared,and the correlation between thyroid hormone levels and cardiac function was analyzed.Results At baseline,the LVEDD,LVEDV,and E/e'of patients in group R and group NR were significantly higher than those in group C(P<0.05),while GLS,GCS,Septal-LS,and Lateral-LS were significantly lower than those in group C(P<0.001),and MD was significantly higher than that in group C(P<0.001).After treatment,the GLS,GCS,Septal-LS,Lateral-LS and MD of patients in group R showed significant improvement compared to before treatment(P<0.01),while GLS,GCS,Septal-LS and MD in group NR showed further deterioration compared to before treatment(P<0.05).The correlation analysis revealed that the level of serum free triiodothyronine was moderately negatively correlated with GLS(r=-0.582,P<0.001).Conclusion 2D-STE can sensitively assess the changes in left ventricular function of patients with hyperthyroidism.Those with well-controlled thyroid function can have their ventricular function approaching the normal level,while those with poor control will have more severe impairment of ventricular function.
王菲;程扬眉;刘海华;姚志正;周浩然;杭天
安徽医科大学附属安庆第一人民医院超声医学科,安徽 安庆 246001安徽医科大学附属安庆第一人民医院超声医学科,安徽 安庆 246001安徽医科大学附属安庆第一人民医院超声医学科,安徽 安庆 246001安徽医科大学附属安庆第一人民医院超声医学科,安徽 安庆 246001安徽医科大学附属安庆第一人民医院超声医学科,安徽 安庆 246001安徽医科大学附属安庆第一人民医院超声医学科,安徽 安庆 246001
医药卫生
甲状腺功能亢进症二维斑点追踪超声心动图整体纵向应变左心室功能
HyperthyroidismTwo-dimensional speckle tracking echocardiographyGlobal longitudinal strainLeft ventricular function
《中国现代医生》 2026 (22)
44-48,5
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