摘要
目的 探讨介入下肺动脉造影相关血管测量参数在预测慢性肺血栓栓塞性肺动脉高压患者中的应用价值。方法 回顾性分析自2017年06月至2019年01月在昆明市第一人民医院呼吸与危重症医学科行介入下肺动脉造影的42例患者的临床资料,将其中明确诊断为慢性血栓栓塞性肺动脉高压的20例患者作为研究组,肺动脉收缩压(PASP)>30mmHg;无肺动脉栓塞的22例患者作为对照组,肺动脉收缩压(PASP)<25mmHg。在DSA图像上测量肺动脉主干、右肺动脉主干及左肺动脉主干直径。将测得的研究组与对照组各血管径线之间的差异应用t检验进行分析,并对有统计学意义的血管参数应用ROC曲线进行分析,以评估各组血管参数诊断和预测肺动脉高压的特异性及敏感性。结果 对照组肺动脉主干直径、右肺动脉主干直径、左肺动脉主干直径分别为(26.38±2.82)mm、(20.66±1.74mm)、(19.79±1.6)mm,均小于研究组(33.80±4.13)mm、(28.79±3.28)mm、(24.85±2.97)mm,差异值均具有统计学意义(P<0.001)。各组肺动脉直径在ROC曲线下面积分别为0.901、0.989、0.924(P<0.001),对比3组数值,其在诊断及预测肺动脉高压的敏感度相似,特异度以右肺动脉主干直径最高。结论 介入下肺动脉造影作为诊断肺动脉栓塞的金标准,可以通过测量主肺动脉直径及右肺动脉直径、左肺动脉直径等血管参数来研究及预测肺动脉高压,能为临床病情评估及治疗方案的选择提供帮助。
Objective To investigate the value of pulmonary angiography-related vascular measurement parameters in predicting chronic pulmonary thromboembolic pulmonary hypertension.Methods Forty-two patients who underwent pulmonary angiography were all from the Department of Respiratory and Critical Care Medicine of the First People's Hospital of Kunming , hospitalized during June 2017 to January 2019, and their clinic data were retrospectively analyzed. Among them, Twenty patients with a clear diagnosis of chronic thromboembolic pulmonary hypertension which means Pulmonary systolic pressure (PASP)> 30 mmHg (1 mmHg = 0.133 kPa)were included in the study group. Twenty-two patients without pulmonary embolism served as a control group with pulmonary systolic blood pressure(PASP)< 25 mmHg. WE measured the diameters of the main pulmonary artery,the right pulmonary artery trunk,and the left pulmonary artery trunk on the DSA image. The difference between the measured vascular diameters of the study group and the control group was analyzed by T test, and the statistically significant vascular parameters were analyzed by ROC curve to assess the specificity and sensitivity of each group of vascular parameters for the diagnosis and prediction of pulmonary hypertension.Results In the control group, the diameter of the main pulmonary artery, the diameter of the right pulmonary artery, and the diameter of the left pulmonary artery were(26.38 ± 2.82)mm,(20.66±1.74 mm), and (19.79 ± 1.6) mm, respectively,which were smaller than those in the study group(33.80±4.13)mm,(28.79±3.28)mm,(24.85±2.97)mm,and the difference values were statistically significant(P < 0.001). The areas of the pulmonary artery in each group was 0.901,0.989,and 0.924(P < 0.001) under the ROC curve. The sensitivity of the three groups was similar in the diagnosis and prediction of pulmonary hypertension,but the diameter of the right pulmonary artery had highest specificity.Conclusion Interventional pulmonary angiography used as a gold standard for the diagnosis of pulmonary embolism can be used to measure and predict pulmonary hypertension by measuring vascular parameters such as main pulmonary artery diameter, right pulmonary artery diameter,and left pulmonary artery diameter. It can provide help for clinical evaluation and a better treatment plan selection.
作者
任朝凤
杨丽芬
刘芬
赵娅琳
李梅华
REN Chao-feng;YANG Li-fen;LIU Fen;ZHAO Ya-lin;LI Mei-hua(Dept.of Respiratory and Critical Care Medicine,The First People’s Hospital of Kunming,Kunming Yunnan 650011,China)
出处
《昆明医科大学学报》
CAS
2019年第10期146-149,共4页
Journal of Kunming Medical University
基金
昆明市卫生和计划生育委员会科研基金资助项目（2018-03-02-002）
关键词
介入下肺动脉造影
慢性血栓栓塞
肺动脉高压
Interventional pulmonary angiography
Chronic thromboembolism
Pulmonary hypertension
