CAJ | 학술논문

目的探讨瞬时波强(wave intensity,WI)参数评价甲状腺功能亢进(甲亢)患者131I治疗前后颈动脉血流动力学变化的应用价值.方法 47例甲亢患者作为甲亢组,47例健康志愿者作为对照组,均行颈总动脉WI检查,测量WI曲线两个正向峰的高度(W1、W2)及负向峰面积(NA),并计算NA的平方根值(A).甲亢组中25例接受131I治疗者作为治疗组,于治疗后3个月随访测量上述参数,比较治疗前、后各参数的变化.分析上述WI参数与甲状腺功能指标的相关性.随机抽取甲亢组和对照组受检者各10名,由同一检查者对WI各参数连续测量两次,检验WI测量重复性.结果 ①独立样本t检验显示:甲亢组较对照组W1、W2、A升高,差异有统计学意义(P=0.000;P=0.000;P=0.000).②配对t检验显示:治疗组患者131I治疗后较治疗前W1、A降低,差异有统计学意义(P=0.001;P=0.011).③相关分析显示:甲亢组A与FT3正相关(r=0.508,P=0.003);治疗组治疗后W1与FT3、FT4正相关(r=0.601,P=0.002;r=0.680,P=0.000),W2与FT3、FT4正相关(r=0.549,P=0.005;r=0.570,P=0.004).④同一检查者连续测量WI参数W1、W2、NA、A,重复性尚好.结论甲亢患者颈总动脉WI检测峰值参数较正常人增高,部分敏感参数治疗后降低.WI检测对131I治疗疗效评估提供了依据.
목적 탐토순시파강(wave intensity,WI)삼수평개갑상선공능항진(갑항)환자131I치료전후경동맥혈류동역학변화적응용개치.방법 47례갑항환자작위갑항조,47례건강지원자작위대조조,균행경총동맥WI검사,측량WI곡선량개정향봉적고도(W1、W2)급부향봉면적(NA),병계산NA적평방근치(A).갑항조중25례접수131I치료자작위치료조,우치료후3개월수방측량상술삼수,비교치료전、후각삼수적변화.분석상술WI삼수여갑상선공능지표적상관성.수궤추취갑항조화대조조수검자각10명,유동일검사자대WI각삼수련속측량량차,검험WI측량중복성.결과 ①독립양본t검험현시:갑항조교대조조W1、W2、A승고,차이유통계학의의(P=0.000;P=0.000;P=0.000).②배대t검험현시:치료조환자131I치료후교치료전W1、A강저,차이유통계학의의(P=0.001;P=0.011).③상관분석현시:갑항조A여FT3정상관(r=0.508,P=0.003);치료조치료후W1여FT3、FT4정상관(r=0.601,P=0.002;r=0.680,P=0.000),W2여FT3、FT4정상관(r=0.549,P=0.005;r=0.570,P=0.004).④동일검사자련속측량WI삼수W1、W2、NA、A,중복성상호.결론 갑항환자경총동맥WI검측봉치삼수교정상인증고,부분민감삼수치료후강저.WI검측대131I치료료효평고제공료의거.
Objective To explore the value of wave intensity (WI) parameters in evaluating hemodynamic changes of cardiovascular system before and after 131I therapy in hyperthyroid patients.Methods Forty-seven hyperthyroid patients were enrolled as hyperthyroid group,while 47 healthy volunteers were considered as control group.Both of the hyperthyroid and control group took WI examinations,and WI curves of their right common carotid arteries were recorded.WI parameters of WI curve were automatically measured as followed:value of the first positive peak (W1),value of the second positive peak (W2),area of the negative peak (NA),and the square root of NA (A).Twenty-five patients of the hyperthyroid group received 131I therapy were enrolled as treatment group.All these patients were followed up for 3 months.The repeatability of the WI parameters was evaluated in 10 hyperthyroid patients and 10 normal volunteers selected at random from the investigation.Results W1,W2,A in hyperthyroid group increased compared with those in control group,and independent-samples t test showed very significant difference (P=0.000,P=0.000,P=0.000).W1,A decreased after 131I therapy compared with those before treatment,and paired-samples t test showed significant difference (W1:P=0.001;A:P=0.011).A in hyperthyroid group had positive correlation with FT3 (r=0.508,P=0.003);W1 after 131I therapy in treatment group had positive correlation with FT3 and FT4 (r=0.601,P=0.002;r=0.680,P=0.00);W2 after 131I therapy in treatment group had positive correlation with FT3 and FT4 (r=0.549,P=0.005;r=0.570,P=0.004).The repeatability of W1,W2,NA and A were good by consecutive measurement of identical observer.Conclusions WI peak parameters of hyperthyroid patients were higher than those of healthy volunteers,and some sensitive parameters were decreased after 131I therapy,which may provide the basis for assessing the effectiveness of 131I therapy.