预测CT肺动脉造影联合肺通气灌注显像检查降低肺栓塞复发率的临床价值

发布时间：2018-08-19 17:07

【摘要】：目的:评估采用CT肺动脉造影(CTPA)联合肺通气灌注显像(V/Q)的检查方法指导肺栓塞抗凝治疗终点,对于减少肺栓塞复发率的临床价值。方法:159例经CTPA确诊的肺栓塞患者随机分为实验组80例及对照组79例,实验组经正规低分子肝素联合华法林抗凝治疗后采用CTPA联合V/Q显像检查的方法评估肺栓塞吸收情况,进一步指导抗凝治疗终点,评估停止抗凝治疗1年时肺栓塞的复发率,并与单纯采用CTPA指导抗凝治疗终点的对照组对比分析,评估两组复发率的差异。结果:实验组抗凝疗程为(5.90±1.80)个月,较对照组(3.57±1.09)个月显著延长(P0.05);实验组停止抗凝治疗1年时肺栓塞的复发率为7.5%,较对照组复发率(22.8%)明显降低(P0.05);但两组患者抗凝治疗期间的出血率(8.75%vs.3.80%)差异无显著性(P0.05)。结论:采用CTPA联合V/Q显像检查的方法指导肺栓塞抗凝治疗终点,对于降低肺栓塞的复发率具有重要的临床价值。
[Abstract]:Objective: to evaluate the clinical value of CT pulmonary angiography (CTPA) combined with pulmonary ventilation perfusion imaging (V / Q) in guiding the end point of anticoagulant therapy for pulmonary embolism (PE). Methods patients with pulmonary embolism diagnosed by CTPA were randomly divided into experimental group (n = 80) and control group (n = 79). After regular low molecular weight heparin (LMWH) combined with warfarin anticoagulant therapy, CTPA combined with V / Q imaging was used to evaluate the pulmonary embolism absorption in the experimental group. To further guide the end point of anticoagulant therapy, to evaluate the recurrence rate of pulmonary embolism at one year after stopping anticoagulant therapy, and to evaluate the difference between the two groups in the recurrence rate of pulmonary embolism compared with the control group which only used CTPA to guide the end point of anticoagulant therapy. Results: the course of anticoagulant treatment in the experimental group was (5.90 卤1.80) months. Compared with the control group (3.57 卤1.09) months, the recurrence rate of pulmonary embolism in the experimental group was 7.5, significantly lower than that in the control group (22.8%) (P0.05), but there was no significant difference between the two groups during anticoagulant therapy (8.75vs.3.80%) (P0.05). Conclusion: using CTPA combined with V / Q imaging to guide the end point of anticoagulant therapy for pulmonary embolism has important clinical value in reducing the recurrence rate of pulmonary embolism.
【作者单位】：温州医学院附属东阳医院呼吸内科;
【基金】：金华市科技计划公益项目(编号:2017-04-25)
【分类号】：R563.5

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