【摘要】：目的：利用超聲心動(dòng)圖獲得甲狀腺功能亢進(jìn)癥病人檢測(cè)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(shì)；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(biāo)，實(shí)現(xiàn)對(duì)甲狀腺功能亢進(jìn)癥病理狀態(tài)下心臟功能演變的動(dòng)態(tài)監(jiān)測(cè)和中長期預(yù)報(bào)，為該疾病引起的心臟疾病的一級(jí)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(cè)確診的未經(jīng)治療和治療不規(guī)范的甲狀腺功能亢進(jìn)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(biāo)和相關(guān)指標(biāo)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(dòng)圖（2DE）獲取FS(縮短分?jǐn)?shù))，，EF(射血分?jǐn)?shù))，SV(每搏量)，CO(心排血量)，CI(心臟指數(shù))，E(二尖瓣舒張?jiān)缙诜逯邓俣?，A(舒張晚期心房收縮峰值速度)，E/A，DT(減速時(shí)間)，IVRT(等容舒張時(shí)間)，IVCT(等容收縮時(shí)間)，VP(彩色M型多普勒左心室舒張?jiān)缙诙獍昕谘鱾鞑ニ俣?，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(yùn)動(dòng)位移，三尖瓣環(huán)收縮期峰值運(yùn)動(dòng)速度，右室Tei指數(shù)（MPI指數(shù)），LVET（左室射血時(shí)間）,SRe/SRa并測(cè)量。將測(cè)量的心臟功能的各項(xiàng)指標(biāo)、形體指標(biāo)與相關(guān)指標(biāo)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(biāo)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(jìn)心臟功能及其變化的特征性指標(biāo)。 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(shì)圖；通過對(duì)甲亢心臟功能的各項(xiàng)指標(biāo)與相關(guān)影響因素進(jìn)行分析，根據(jù)各指標(biāo)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(yùn)動(dòng)位移，三尖瓣環(huán)收縮期峰值運(yùn)動(dòng)速度，右室Tei指數(shù)（MPI指數(shù)），VP，LVET（左室射血時(shí)間），SRe/SRa等指標(biāo)在甲亢時(shí)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(rèn)為反映甲亢心臟功能的特征性指標(biāo)，以實(shí)現(xiàn)對(duì)甲亢心臟演變的動(dòng)態(tài)監(jiān)測(cè)和中長期預(yù)報(bào)，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(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.1;R581.1

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