| 摘要: |
| 摘 要 目的 应用实时三维超声心动图（RT-3DE）技术评价亚临床甲状腺功能减低（SCH）患者治疗前后左心房结构和功能变化。方法 入选31例临床诊断为亚临床甲状腺功能减低（SCH）并接受左旋甲状腺素片治疗同时随访甲状腺功能者，分为治疗前组、治疗后组，33例健康对照组。当甲状腺功能达正常水平三个月后随访超声心动图，比较治疗前后左心房结构参数及功能变化。左心房参数包括：左心房最大容积（LAVmax）、左房收缩前容积( LAVpre)、左房最小容积(LAVmin)。计算左心房总排空指数（LAEF）、左心房被动排空指数（LApEF）及左心房主动排空指数（LAaEF）。同时获得应变参数：左心房储备期应变（ LASr）、左心房管道期应变（LAScd）、左心房收缩期应变（LASct）。结果 （1）与对照组及治疗后相比，治疗前LAVpre、LAVmin、LAaEF均增加（P<0.05），LAEF、LApEF均减低（P<0.05）；三组间LAVmax差异无统计学意义（P>0.05）。（2）治疗后LAVmax、LAVpre、LAVmin、LAEF、LApEF、LAaEF与对照组相比差异无统计学意义（P>0.05）。（3）与对照组及治疗后相比，治疗前LASr、LAScd减低,，LASct增加差异均有统计学意义（P<0.05）；与对照组相比，治疗后LASr、LAScd减低，LASct增加差异均有统计学意义（P<0.05）。（4）Pearson相关分析法检测治疗前TSH水平与LAEF、LApEF、LAaEF的相关性：TSH水平与LAEF之间无相关性（r=0.16，P=0.39）与LApEF之间呈负相关（r=- 0.44，P=0.01），与LAaEF之间呈正相关（r=0.45，P=0.01）。结论：本研究主要证明了RT-3DE技术可早期发现SCH患者左心房容积和机械功能损伤，当接受左旋甲状腺素片治疗后左心房损伤情况明显改善。 |
| 关键词: 实时三维超声心动图 亚临床甲状腺功能减低 左心房功能 |
| DOI： |
| 投稿时间：2020-03-01修订日期：2020-03-14 |
| 基金项目: |
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| Evaluation of left atrial function before and after treatment with subclinical hypothyroidism by real-time three-dimensional echocardiography |
| wu dang jie,li yu qian |
| (First Affiliated Hospital of Air Force Medical University) |
| Abstract: |
| ABSTRACT Objective To evaluate the changes in left atrium structure and function in patients with subclinical hypothyroidism before and after treatment by real-time three-dimensional echocardiography (RT-3DE) . Methods 31 patients with clinical diagnosis of subclinical hypothyroidism (SCH) and received levothyroxine therapy were selected as the case group: pre-treatment group and post-treatment group, 33 healthy controls. All patients with SCH were followed up with replacement therapy until the euthyroid status was achieved. Echocardiography was followed up three months after normal euthyroid status.Comparison of structural parameters and functional changes of left atrium before and after treatment. Left atrial parameters include: left atrial maximum volume (LAVmax), left atrial pre-systolic volume (LAVpre), and left atrial minimum volume (LAVmin). The left atrial total emptying index (LAEF), the left atrial passive emptying index (LApEF) and the left atrial active emptying index (LAaEF) were calculated. Strain parameters were also obtained: left atrium strain during reservoir (LASr), left atrium strain during conduit (LAScd), left atrium strain during contraction (LASct). Results (1) Compared with the control group and after treatment, LAVpre, LAVmin, and LAaEF increased before treatment (P <0.05), and LAEF and LApEF decreased (P <0.05); there was no significant difference in LAVmax between the three groups (P> 0.05). (2) There was no significant difference in LAVmax, LAVpre, LAVmin, LAEF, LApEF, LAaEF after treatment compared with the control group (P> 0.05). (3) Compared with the control group and after treatment, the LASr and LAScd decreased before treatment, and the increase in LASct was statistically significant (P <0.05). Compared with the control group, the LASr and LAScd decreased after treatment, and the LASct increased. All were statistically significant (P <0.05). (4) Pearson correlation analysis was used to detect the correlation between TSH levels and LAEF, LApEF, and LAaEF before treatment: we found there was no correlation between TSH levels and LAEF (r = 0.16, P = 0.39), negative correlation between LApEF (r = -0.44, P = 0.01), positive correlation with LAaEF (r = 0.45, P = 0.01). Conclusion This study mainly proved that RT-3DE technology can detect the left atrial volume and mechanical function damage in patients with SCH at an early stage, and the left atrial damage was significantly improved after receiving levothyroxine therapy . |
| Key words: Real-time three-dimensional echocardiography Subclinical hypothyroidism Left atrium function |
