甲状腺功能亢进症心脏功能超声数据模型的初步研究

发布时间：2018-09-05 08:04

【摘要】：目的：利用超声心动图获得甲状腺功能亢进症病人检测的基础数据，并应用数据挖掘技术建立心脏功能数据模型，从而揭示生理及不同病理状态下心脏功能的特征及变化规律或趋势；并从基础数据中优选出反映心脏功能及其变化的特征性指标，实现对甲状腺功能亢进症病理状态下心脏功能演变的动态监测和中长期预报，为该疾病引起的心脏疾病的一级预防、早期干预及流行病学调查等提供决策支持。方法：选取2012年11月至2014年1月底在我院就诊，经检测确诊的未经治疗和治疗不规范的甲状腺功能亢进症患者150例及同期健康体检者150例，并记录受试者的性别、年龄、身高、体重及体表面积等形体指标和相关指标的影响因素如血压、心率、血脂、血糖、遗传因素，是否吸烟，是否高钠高蛋白饮食、是否有并发症等。通过二维超声心动图（2DE）获取FS(缩短分数)，，EF(射血分数)，SV(每搏量)，CO(心排血量)，CI(心脏指数)，E(二尖瓣舒张早期峰值速度)，A(舒张晚期心房收缩峰值速度)，E/A，DT(减速时间)，IVRT(等容舒张时间)，IVCT(等容收缩时间)，VP(彩色M型多普勒左心室舒张早期二尖瓣口血流传播速度)，S，D，S/D，Ar，Ar-A，Setpal e’，Latal a’，E/e’，右室面积变化率，三尖瓣环收缩运动位移，三尖瓣环收缩期峰值运动速度，右室Tei指数（MPI指数），LVET（左室射血时间）,SRe/SRa并测量。将测量的心脏功能的各项指标、形体指标与相关指标的影响因素相结合，建立心脏功能超声数据模型，然后根据各指标权重系数的大小从基础数据中优选出反映甲状腺功能亢进心脏功能及其变化的特征性指标。结果：建立了正常人和甲亢人群的心脏功能超声数据模型，并绘制出趋势图；通过对甲亢心脏功能的各项指标与相关影响因素进行分析，根据各指标权重系数的大小，显示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’，右室面积变化率，三尖瓣环收缩运动位移，三尖瓣环收缩期峰值运动速度，右室Tei指数（MPI指数），VP，LVET（左室射血时间），SRe/SRa等指标在甲亢时倾向于发生改变。结论：左房容积指数，EF，E/A，DT，IVRT，IVCT，Setpal e’，Latal e’，E/e’，右室面积变化率，右室Tei指数（MPI指数）及二维应变成像SRe/SRa的比值可以认为反映甲亢心脏功能的特征性指标，以实现对甲亢心脏演变的动态监测和中长期预报，为甲亢的防治提供决策支持。
[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.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R581.1

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