摘要
目的探讨超声心动图对急性肺栓塞(APE)患者预后的预测价值。方法选择我院2005年1月—2009年3月收治的行超声心动图检查的APE患者63例,回顾性分析其病历资料及超声心动图检查结果,根据右室功能障碍(RVD)发生情况分为RVD组22例与非RVD组41例;根据右室舒张末直径与左室舒张末直径比值(RVED/LVED)分为RVED/LVED≥0.65组19例与RVED/LVED<0.65组44例。比较各组住院期间病死率、住院期间不良事件发生率及随访3个月病死率。结果 RVD组与非RVD组住院期间病死率比较,差异无统计学意义(P>0.05);RVD组住院不良事件发生率、随访3个月病死率均高于非RVD组(P<0.05)。RVED/LVED≥0.65组住院期间病死率、住院期间不良事件发生率、随访3个月病死率均高于RVED/LVED<0.65组(P<0.05);绘制ROC曲线发现,RVED/LVED预测APE患者住院期间死亡的最佳临界值为0.73,取最佳临界值时其灵敏度为71.4%,特异度为91.1%。结论存在RVD和/或RVED/LVED≥0.65(尤其是≥0.73)的APE患者住院期间病死率、住院期间不良事件发生率及随访3个月病死率较高,超声心动图对APE患者预后有较高的预测价值。
Objective To investigate the predictive value of echocardiography on prognosis in patients with acute pulmonary embolism（ APE）. Methods From January 2005 to March 2009,a total of 63 patients with APE underwent echocardiography in our hospital were selected,and then their medical history and examination results of echocardiography were retrospectively analyzed. According to the occurrence of right ventricular dysfunction（ RVD）,they were divided into RVD group（ n =22） and non- RVD group（ n = 41）; according to the ratio of right ventricular end- diastolic diameter（ RVED） and left ventricular end- diastolic diameter（ LVED）,they were divided into RVED /LVED≥0. 65 group（ n = 19） and RVED /LVED 〈0. 65 group（ n = 44）. Fatality rate during hospitalization,incidence of adverse events during hospitalization and fatality rate during 3- month fellow- up were compared in each group. Results There was no significant differences of fatality rate during hospitalization between RVD group and non- RVD group（ P〉0. 05）; incidence of adverse events during hospitalization and fatality rate during 3- month fellow- up of RVD group were higher than those of non- RVD group（ P〈0. 05）. Fatality rate during hospitalization,incidence of adverse events during hospitalization and fatality rate during 3- month fellow- up of RVED /LVED≥0. 65 group were higher than those of RVED /LVED 0. 65 group（ P〈0. 05）; ROC curve showed that,the best threshold of RVED /LVED for predicting death during hospitalization in patients with APE was 0. 73,while the sensitivity was71. 4%,specificity was 91. 1%. Conclusion APE patients with RVD and（ or） RVED /LVED≥0. 65（ especially ≥0. 73）have a higher fatality rate during hospitalization,higher incidence of adverse events during hospitalization and higher fatality rate during 3- month fellow- up,echocardiography has a certain predictive value on prognosis in patients with APE.
出处
《实用心脑肺血管病杂志》
2014年第10期16-18,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
肺栓塞
超声心动描记术
右室功能障碍
预后
Pulmonary embolism
Echocardiography
Right ventricular dysfunction
Prognosis
