摘要
目的:探讨肺动脉高压对甲状腺功能亢进(甲亢)性心脏病的早期诊断价值。方法:应用彩色多普勒超声诊断技术评价了75例甲亢患者的肺动脉压,其中单纯甲亢患者34例,甲亢性心脏病(甲亢心)患者41例,92例为健康对照组。用放射免疫法测定了所有受试者治疗前后的甲状腺功能、血浆内皮素(ET1)、血管紧张素Ⅰ(A1)及血管紧张素Ⅱ(A2)的含量。结果:34例甲亢组患者检出肺动脉高压12例(32.4%),41例甲亢心患者检出肺动脉高压39例(94.5%)(P<0.05)。单纯甲亢组中12例肺动脉高压患者有4例在2～6月之内发生了心房颤动。甲亢患者血浆中ET1、A1及A2水平显著高于对照组(P<0.01)。结论:用彩色多普勒超声诊断技术检出的肺动脉高压,是甲亢心的早期诊断指标,其敏感度为81%,特异度为92.59%,阳性预测值为96.23%,阴性预测值为67.57%。是一个实用的无创早期诊断方法。肾素-血管紧张素-醛固酮系统被激活可能参与了肺动脉高压的形成过程。
Objective:To study the diagnostic value of pulmonary hypertension in early hyper-throid cardiopathy.Methods:Color Doppler ultrasound diagnostic t echnique was used to detect the pul-monary pressure of75cases with hyperthyro idism,including,41cases with hyperthyroid cardiopathy and34cases with simp le hyperthyroidism.Ninety-two health y subjects were also detcted.Eadioim-m unoassay was used to determine thyroid function,plasma endothelin(ET 1 ),angiotensinⅠ(A 1 )and angiotensinⅡ(A 2 )in the health group and the patient group before and after treatment .Re sults:Thirty-nine cases(94.5%)and12cases(32.4%)with pulmonary hypertension were found out from patients with hyperthyroid cardiopathy and one s with simple hyperthyroidism,rsepectiely (P<0.05).Four of12cases wi th pulmonary hypertension in simple hyperthyroidism group had atrial flutter wit h in one month.Contents of ET 1 ,A 1 ,and A 2 of patients with hyperthyroidism were significantly higher than those of hea lthy group(P<0.01).Conclusion:Determination of pulmonary hypertension i n patients with hyperthy-roidism by Color Doppler ultrasound diagnostic techniq ue is a diagnostic index for early hyperthyroid cardiopathy.The sensitivity is 81.00%and specificity92.59%.The positive prediction value is96. 23%and negative prediction value67.57%.It is a practical,non-invasiv e early diagnostic method.The acti-vation of renin system may play a role in t he formaion of pulmonary hypertension.
出处
《山东大学学报（医学版）》
CAS
2003年第6期670-672,共3页
Journal of Shandong University:Health Sciences
