CMR评估肺高血压:肺高血压患者与健康志愿者对照研究

发布时间：2018-07-05 20:37

本文选题：心脏 + 核磁共振　；参考：《中国肺癌杂志》2016年05期

【摘要】：背景与目的肺高血压(pulmonary hypertension,PH)临床病程表现为进行性恶化和间断急性失代偿发作,死亡可突然或缓慢发生,而临床医生往往对病情的进展评估不足。本研究旨在应用心脏核磁共振(cardiac magnetic resonance,CMR)评估PH患者右心室(right ventricle,RV)形态、功能及主肺动脉(main pulmonary artery,MPA)血液动力学,并与健康人对照,探讨CMR在检出PH中的临床应用价值。方法对56例PH患者及22例健康志愿者进行CMR扫描并获得RV舒张末期容积(end-diastolic volume,EDV)、收缩末期容积(end-systolic volume,ESV)、射血分数(ejection fraction,EF)、心肌质量(myocardial mass,MM)、RV面积变化分数(RV fractional area change,RVFAC)、室间隔与左室游离壁曲率比,MPA正向峰值流速、最大截面积、最小截面积及顺应性。PH组与对照组测量结果采用两独立样本t检验进行比较。受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)用于比较MPA正向峰值流速、顺应性、曲率比、RVFAC单项指标及综合评估检出PH的效能。P0.05为差异有统计学意义。结果与对照组相比,PH组RV形态改变、功能明显下降,血液动力学指标恶化。顺应性对检出PH的效能较高(AUC为0.950);综合应用正向峰值流速、顺应性、曲率比和RVFAC时,检出PH的效能最高(AUC为0.988)。结论 CMR综合评估指标有利于准确反映PH患者RV-肺循环整体状态。
[Abstract]:Background and objective the clinical course of pulmonary hypertension (PH) is progressive and intermittent acute decompensated attack, and death can occur suddenly or slowly, while clinicians often do not assess the progress of the disease. The purpose of this study is to evaluate the right ventricle of PH patients with cardiac magnetic resonance (CMR). Right ventricle, RV) morphology, function and the hemodynamics of the main pulmonary artery (main pulmonary artery, MPA), and compared with the healthy people, to explore the clinical value of CMR in the detection of PH. Methods 56 cases of PH patients and 22 healthy volunteers were carried out CMR scan and the volume of terminal systolic volume was obtained. Tolic volume, ESV), blood ejection fraction (ejection fraction, EF), myocardial mass (myocardial mass, MM), RV area change fraction (RV fractional), ventricular septum and left ventricular free wall curvature ratio, maximum frontal peak velocity, maximum section area, minimum section area and compliance group and control group measured by two independent samples Comparison. The subjects' work characteristic curves (receiver operating characteristic curve, ROC curve) were used to compare the positive peak velocity of MPA, the compliance, the curvature ratio, the RVFAC single index and the efficiency.P0.05 of PH in the comprehensive evaluation were statistically significant. The results were compared with the MPA group, the RV morphology of the PH group was changed, the function decreased significantly. The performance of PH was more effective (AUC 0.950), and the maximum efficiency of positive peak flow velocity, compliance, curvature ratio and RVFAC was the highest (AUC 0.988). Conclusion CMR comprehensive evaluation index is beneficial to accurately reflect the whole state of RV- lung in PH patients.
【作者单位】：天津医科大学总医院放射科;天津医科大学总医院心内科;
【基金】：教育部博士点基金课题(No.20121202110005) 国家自然科学基金项目(No.81301217) 国家临床重点专科建设项目天津市应用基础与前沿技术研究计划重点项目(No.14JCZDJC57000)资助~~
【分类号】：R445.2;R544.1

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