摘要
目的:探讨128层螺旋CT肺动脉造影(CTPA)对急性肺栓塞(APE)患者栓塞程度和右心功能的评估价值。方法:选取2016年7月到2018年6月期间在我院行CTPA检查确诊并接受治疗的APE患者100例记为观察组,根据观察组患者的病情将其分为高危组(57例)和非高危组(43例),同时根据观察组患者肺栓塞部位及预后将患者分为中心肺栓塞死亡组(8例)、中心肺栓塞存活组(38例)、周围肺栓塞组(54例)。另选择同期于我院进行CTPA检查的无肺栓塞患者50例记为对照组。记录所有患者的右心功能参数[右心室短轴最大径(RVMSA)、左心室短轴最大径(LVMSA)以及二者的比值(RV:LV)],计算APE患者的CT肺动脉阻塞指数,并分析APE患者CT肺动脉阻塞指数与右心功能指标的相关性。结果:观察组的RVMSA、RV:LV均明显高于对照组(P<0.05),高危组的CT肺动脉阻塞指数、RVMSA、RV:LV均明显高于非高危组(P<0.05)。中心肺栓塞死亡组的CT肺动脉阻塞指数、RVMSA、RV:LV均明显高于中心肺栓塞存活组和周围肺栓塞组,中心肺栓塞存活组的CT肺动脉阻塞指数、RVMSA、RV:LV均明显高于周围肺栓塞组(P<0.05)。经Pearson相关分析显示,APE患者CT肺动脉阻塞指数与RVMSA、RV:LV均呈正相关(P<0.05),与LVMSA无明显的相关性(P>0.05)。结论:CTPA检查可有效评估APE患者的栓塞程度和右心功能,且栓塞程度与右心功能存在相关性,CTPA检查有助于APE患者的诊断和病情评估。
Objective: To explore the value of 128-slice spiral CT pulmonary angiography(CTPA) in evaluating the degree of embolism and right ventricular function in patients with acute pulmonary embolism(APE). Methods: A total of 100 patients with APE, who were diagnosed and treated by CTPA in the First People’s Hospital of Ziyang from July 2016 to June 2018, were chosen as observation group. According to the patient’s condition, they were divided into high-risk group(57 cases) and non-high-risk group(43 cases). At the same time, according to the location and prognosis of pulmonary embolism, the patients in the observation group were divided into three groups: central pulmonary embolism death group(8 cases), central pulmonary embolism survival group(38 cases) and peripheral pulmonary embolism group(54 cases). Another 50 patients without pulmonary embolism, who underwent CTPA examination in the hospital during the same period, were chosen as control group. The right ventricular function parameters [maximum diameter of right ventricular short axis(RVMSA), maximum diameter of left ventricular short axis(LVMSA) and their ratios(RV: LV)] were recorded in all patients.And CT pulmonary occlusion index in the patients with APE was calculated. The correlation between CT pulmonary artery occlusion index and right ventricular function index in APE patients was analyzed. Results: The RVMSA and RV: LV in the observation group were significantly higher than those in the control group(P<0.05). The CT pulmonary artery occlusion index, RVMSA and RV: LV in high-risk group were significantly higher than those in non-high-risk group(P<0.05). The CT pulmonary artery occlusion index, RVMSA and RV: LV in the central pulmonary embolism death group were significantly higher than those in the central pulmonary embolism survival group and peripheral pulmonary embolism group. The CT pulmonary artery obstruction index, RVMSA and RV: LV in the central pulmonary embolism survival group were significantly higher than those in peripheral pulmonary embolism group(P<0.05). Pearson analysis showed that CT pulmonary artery obstruction index was positively correlated with RVMSA and RV: LV in APE patients(P<0.05),but no obvious correlation with LVMSA(P>0.05). Conclusion: CTPA examination can effectively evaluate the degree of embolism and right heart function in APE patients, and the degree of embolism is correlated with right heart function. CTPA examination is helpful in diagnosing and evaluating APE patients.
作者
马青松
张静
罗露露
李静
周小英
MA Qing-song;ZHANG Jing;LUO Lu-lu;LI Jing;ZHOU Xiao-ying(Department of Radiology,The First People's Hospital of Ziyang/Ziyang Hospital,West China Hospital,Sichuan University,Ziyang,Sichuan,641300,China;Department of Gastroenterology,The First People's Hospital of Ziyang/Ziyang Hospital,West China Hospital,Sichuan University,Ziyang,Sichuan,641300,China)
出处
《现代生物医学进展》
CAS
2019年第9期1731-1734,1757,共5页
Progress in Modern Biomedicine
基金
四川省医学科研青年创新计划项目(Q15039)
关键词
多层螺旋CT肺动脉造影
急性肺栓塞
栓塞程度
右心功能
评估价值
Multi-slice spiral CT pulmonary angiography
Acute pulmonary embolism
Degree of embolism
Right heart function
Evaluation value
