超声心动图吸入型伊洛前列素试验诊断肺栓塞的研究

发布时间：2018-04-06 05:16

本文选题：超声心动图　切入点：伊洛前列素　出处：《泰山医学院》2012年硕士论文

【摘要】：目的：应用超声心动图评价伊洛前列素在急性肺动脉栓塞(APE)诊断中的应用价值。方法：自2010年5月至2012年2月来我院就诊的疑诊急性肺栓塞的患者中，应用超声心动图筛选出存在肺动脉高压、三尖瓣返流、疑诊急性肺栓塞的患者36人。应用多排螺旋CT肺动脉增强造影或（和）核素肺灌注扫描为确诊方法，36名患者均雾化吸入伊洛前列素，超声心动图依次估测患者雾化吸入前、即刻、5分钟、10分钟、30分钟时最大肺动脉压。并以雾化吸入前患者肺动脉压为基线，如肺动脉压下降幅度小于5mmHg为阳性，下降幅度大于或等于5mmHg为阴性。通过ROC法(ReceiverOperating Characteristic Cure)来评价吸入伊洛前列素在诊断急性肺栓塞的特异性及敏感性。结果：采用多排螺旋CT肺动脉增强造影或（和）核素肺灌注扫描对36名疑诊肺栓塞的患者进行检查，确诊急性肺栓塞26人，无肺栓塞10人。将确诊患者为急性肺栓塞（APE）组，无肺栓塞的患者为无肺栓塞（NPE）组。观察入选患者吸入伊洛前列素后即刻、5分钟、10分钟、30分钟超声心动图所观测到的阳性例数分别为18、8，16、4，22、4，，22、2。由上可得超声心动图加伊洛前列素(万他维)诊断肺栓塞在即刻、5分钟、10分钟、30分钟的敏感性、特异性为：69.23%、20.00%，61.54、60.00%，84.62%、60.00%，84.62%、80.00%。结论：超声心动图联合吸入伊洛前列素试验诊断肺栓塞是一种无创、安全、方便、可床旁操作，敏感性高的诊断肺栓塞的方法之一。因此该试验对筛选急性肺栓塞有很大的应用价值。
[Abstract]:Objective:To evaluate the diagnostic value of iloprostol in acute pulmonary embolism (APE) by echocardiography.Methods:From May 2010 to February 2012, 36 patients with pulmonary hypertension, tricuspid regurgitation and suspected acute pulmonary embolism were selected by echocardiography.Multislice spiral CT pulmonary arteriography or / and radionuclide pulmonary perfusion scanning were used as a diagnostic method. All 36 patients were inhaled with iloprostatin, and echocardiography was used to estimate the time before aerosol inhalation.The maximum pulmonary artery pressure was 5 minutes, 10 minutes and 30 minutes, respectively.The pulmonary artery pressure before atomization inhalation was taken as the baseline, if the decrease of pulmonary artery pressure was less than 5mmHg as positive, and the decrease was greater than or equal to 5mmHg as negative.The specificity and sensitivity of inhaled iloprostatin in the diagnosis of acute pulmonary embolism were evaluated by ROC method with receiver operating Characteristic.Results:Multi-slice spiral CT pulmonary angiography or / or radionuclide pulmonary perfusion scanning were used to examine 36 patients with suspected pulmonary embolism. 26 patients were diagnosed as acute pulmonary embolism and 10 patients had no pulmonary embolism.The patients with acute pulmonary embolism (APE) and patients without pulmonary embolism (NPE) were diagnosed as acute pulmonary embolism (APE) group and non pulmonary embolism (NPE) group.The number of positive cases observed by echocardiography immediately after inhaling iloprostatin was 18 ~ 816 ~ 4 ~ 22 ~ 22 ~ (22) minutes after inhaling iloprostatin for 5 minutes and 10 ~ 30 minutes after echocardiography, respectively.The sensitivity of echocardiography plus vaniloprostatin in diagnosing pulmonary embolism at 5 minutes and 10 minutes and 30 minutes was obtained. The specificity was 69.23 and 20.00. The specificity was 61.54% 60.0060.0060.0060.0084.62 and 80.002.Conclusion:Echocardiography combined with inhaled iloprost test is a noninvasive, safe, convenient, bedside and highly sensitive method for the diagnosis of pulmonary embolism.Therefore, this test has great application value in screening acute pulmonary embolism.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.5

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