【摘要】：目的：利用超聲心動圖獲得甲狀腺功能亢進癥病人檢測的基礎(chǔ)數(shù)據(jù)，并應(yīng)用數(shù)據(jù)挖掘技術(shù)建立心臟功能數(shù)據(jù)模型，從而揭示生理及不同病理狀態(tài)下心臟功能的特征及變化規(guī)律或趨勢；并從基礎(chǔ)數(shù)據(jù)中優(yōu)選出反映心臟功能及其變化的特征性指標，實現(xiàn)對甲狀腺功能亢進癥病理狀態(tài)下心臟功能演變的動態(tài)監(jiān)測和中長期預(yù)報，為該疾病引起的心臟疾病的一級預(yù)防、早期干預(yù)及流行病學(xué)調(diào)查等提供決策支持。 方法：選取2012年11月至2014年1月底在我院就診，經(jīng)檢測確診的未經(jīng)治療和治療不規(guī)范的甲狀腺功能亢進癥患者150例及同期健康體檢者150例，并記錄受試者的性別、年齡、身高、體重及體表面積等形體指標和相關(guān)指標的影響因素如血壓、心率、血脂、血糖、遺傳因素，是否吸煙，是否高鈉高蛋白飲食、是否有并發(fā)癥等。通過二維超聲心動圖（2DE）獲取FS(縮短分數(shù))，，EF(射血分數(shù))，SV(每搏量)，CO(心排血量)，CI(心臟指數(shù))，E(二尖瓣舒張早期峰值速度)，A(舒張晚期心房收縮峰值速度)，E/A，DT(減速時間)，IVRT(等容舒張時間)，IVCT(等容收縮時間)，VP(彩色M型多普勒左心室舒張早期二尖瓣口血流傳播速度)，S，D，S/D，Ar，Ar-A，Setpal e’，Latal a’，E/e’，右室面積變化率，三尖瓣環(huán)收縮運動位移，三尖瓣環(huán)收縮期峰值運動速度，右室Tei指數(shù)（MPI指數(shù)），LVET（左室射血時間）,SRe/SRa并測量。將測量的心臟功能的各項指標、形體指標與相關(guān)指標的影響因素相結(jié)合，建立心臟功能超聲數(shù)據(jù)模型，然后根據(jù)各指標權(quán)重系數(shù)的大小從基礎(chǔ)數(shù)據(jù)中優(yōu)選出反映甲狀腺功能亢進心臟功能及其變化的特征性指標。 結(jié)果：建立了正常人和甲亢人群的心臟功能超聲數(shù)據(jù)模型，并繪制出趨勢圖；通過對甲亢心臟功能的各項指標與相關(guān)影響因素進行分析，根據(jù)各指標權(quán)重系數(shù)的大小，顯示FS，EF，SV，CO，CI，E，A，E/A，DT，IVRT，IVCT，VP，S，D，S/D，Ar，Ar-A，Setpal e’，Latal a’，E/e’，右室面積變化率，三尖瓣環(huán)收縮運動位移，三尖瓣環(huán)收縮期峰值運動速度，右室Tei指數(shù)（MPI指數(shù)），VP，LVET（左室射血時間），SRe/SRa等指標在甲亢時傾向于發(fā)生改變。 結(jié)論：左房容積指數(shù)，EF，E/A，DT，IVRT，IVCT，Setpal e’，Latal e’，E/e’，右室面積變化率，右室Tei指數(shù)（MPI指數(shù)）及二維應(yīng)變成像SRe/SRa的比值可以認為反映甲亢心臟功能的特征性指標，以實現(xiàn)對甲亢心臟演變的動態(tài)監(jiān)測和中長期預(yù)報，為甲亢的防治提供決策支持。
[Abstract]:Objective: to obtain the basic data of hyperthyroidism patients by echocardiography and to establish a heart function data model by using data mining technology. In order to reveal the characteristics and trends of heart function under different physiological and pathological conditions, and select the characteristic indexes which reflect the heart function and its change from the basic data, To realize the dynamic monitoring and long-term prediction of cardiac function evolution in the pathological state of hyperthyroidism, and to provide decision support for the primary prevention, early intervention and epidemiological investigation of heart disease caused by hyperthyroidism. Methods: 150 cases of untreated and nonstandard hyperthyroidism and 150 cases of health check-up were selected from November 2012 to the end of January 2014 in our hospital. The sex, age, height of the subjects were recorded. Body weight, body surface area and other related factors, such as blood pressure, heart rate, blood lipid, blood sugar, genetic factors, smoking, high sodium and high protein diet, complications and so on. FS (shortened fraction) EF (ejection fraction) SV (stroke volume) CO (cardiac output) CI (cardiac index) E (early diastolic peak velocity of mitral valve) A (late diastolic peak atrial systolic velocity) and E / A (deceleration time) were obtained by two-dimensional echocardiography. IVCT (isovolumic systolic time) VP (color M-Doppler left ventricular early diastolic mitral valve velocity), SDAS / DV, Ar-An Setepal, The change rate of right ventricular area, the systolic displacement of tricuspid annulus, the peak systolic velocity of tricuspid annulus, the right ventricular Tei index (MPI index) and the left ventricular ejection time (LVET) were measured. The echocardiographic data model of cardiac function was established by combining the measured indexes of heart function, body shape index and the influencing factors of related indexes. Then, according to the weight coefficient of each index, the characteristic indexes reflecting the hyperthyroidism heart function and its changes were selected from the basic data. Results: the echocardiographic data model of heart function of normal people and people with hyperthyroidism was established, and the trend map was drawn. By analyzing the indexes of cardiac function of hyperthyroidism and related influencing factors, according to the weight coefficient of each index, The results showed that the change rate of right ventricular area, the systolic displacement of tricuspid annulus, the peak systolic velocity of tricuspid annulus, the Tei index of right ventricle (MPI index), the left ventricular ejection time (LVET) and SReP / SRa tended to change in hyperthyroidism. Conclusion: the left atrial volume index (LVVI), the ratio of Tei index (MPI index) and two-dimensional strain imaging (SRe/SRa) can be regarded as the characteristic index of cardiac function in hyperthyroidism, and the rate of change of right ventricular area (RV), right ventricular area (RV) and two-dimensional strain imaging (SRe/SRa) can be considered as the characteristic index of cardiac function in hyperthyroidism. In order to realize dynamic monitoring and medium and long term prediction of heart evolution in hyperthyroidism, it can provide decision support for prevention and treatment of hyperthyroidism.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.1;R581.1

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