CT肺栓塞指数对急性肺栓塞患者右心功能的评价
发布时间：2018-10-12 10:20
【摘要】：[目的]分析急性肺栓塞(acute pulmonary embolism, APE)患者的CT肺血管成像(CTpulmonary angiography, CTPA)检查、超声心动图(ultrasound cardiogram, UCG)检查及血气分析,探讨APE患者的CT肺动脉栓塞指数(pulmonary artery obstruction index, PAOI)对右心功能的评价。 [方法]收集2011年12月至2012年12月期间,昆明医科大学第二附属医院呼吸内科,己行电子计算机X射线断层扫描技术(computed tomography, CT)检查、血气分析检验、超声心动图检查的,经CTPA确诊为PE、无严重基础心肺疾病、且无活动性出血、近期内未接受抗凝治疗,无明确的慢性血栓栓塞性疾病史的APE患者54例。 分析已确诊为APE的54例患者的CTPA和UCG、血气分析。使用Qanadli等设计的评分方法计算CT阻塞指数,同时经CT测量右心功能参数,主要为心脏径线和血管径线的测量。其中心脏经线包括右室短轴最大直径(right ventricular short axis diameter, RVd)、左室短轴最大直径(left ventricular short axis diameter, LVd)、右室与左室短轴最大直径比(RVd/LVd);血管径线包括主肺动脉直径(main pulmonary artery diameter, MPA)、上腔静脉直径(superior vena cava diameter, SVC)。根据54例APE患者的CT肺动脉栓塞指数(PAOI),按PA0I30%、30%≤PA0I50%和PAOI"g50%,将APE患者分为轻、中和重度三组。分别分析各组经CT测量所得右心功能参数否存在差异,分析经UCG测得右心功能参数是否存在差异,分析各组间血气分析中动脉血氧分压(arterial partial pressure of oxygen, PaO2)及动脉血二氧化碳分压(arterial partial pressure of carbon dioxide, PaC02)间的差异,同时分析经CT测得右心功能参数与UCG测得参数是否存在相关性。 [结果]根据CT肺栓塞指数将54例患者分为轻(36例)、中(13例)、重(5例)三组。 1.三组间经CT测得右心功能参数计量资料的比较 轻度、中度和重度三组CT测得右心功能参数(RVd、LVd、RVd/LVd、SVC、MPA)进行比较,差异有统计学意义(P0.05),LVd呈逐渐减小趋势,RVd、RVd/LVd、SVC,MPA呈逐渐增大趋势。 2.三组间经UCG测得右心功能参数计量资料的比较 轻度、中度和重度三组UCG测得右心功能参数(RVd、LVd、RVd/LVd)进行比较,差异有统计学意义(P0.05),LVd呈逐渐减小趋势,RVd、RVd/LVa呈逐渐增大趋势。 3.三组间血气分析Pa02及PaCO2计量资料的比较 轻度、中度和重度三组血气分析(PaO2、PaCO2)进行比较,PaO2、PaCO2差异有统计学意义(P0.05),呈逐渐减小趋势。 4.经CT测得右心功能参数与经UCG测得右心功能参数相关性比较 经CT测得右心功能参数(RVd、LVd、RVd/LVd)与经UCG测得右心功能参数(RVd、LVd、RVd/LVd)呈正相关。 [结论]通过本研究得出,CT肺栓塞指数对急性肺栓塞患者右心功能的评价具有一定的价值,有助于判定APE患者右心功能的严重程度及分级,从而指导临床合理治疗及评估预后。
[Abstract]:[objective] to investigate the evaluation of right ventricular function by CT pulmonary embolism index (pulmonary artery obstruction index, PAOI) in patients with acute pulmonary embolism (acute pulmonary embolism, APE) by analyzing CT pulmonary angiography (CTpulmonary angiography, CTPA), echocardiography (Echocardiography) (ultrasound cardiogram, UCG) and blood gas analysis (BGE) in patients with acute pulmonary embolism (acute pulmonary embolism, APE). [methods] from December 2011 to December 2012, Department of Respiratory, second affiliated Hospital of Kunming Medical University, were examined by (computed tomography, CT), blood gas analysis and echocardiography. There were 54 cases of PE, diagnosed by CTPA as having no serious basic cardiopulmonary disease and no active bleeding, no anticoagulant therapy and no definite history of chronic thromboembolic disease in the near future. The blood gas analysis of CTPA and UCG, in 54 patients with APE was analyzed. The CT occlusion index was calculated by using the score method designed by Qanadli et al, and the right cardiac function parameters were measured by CT, mainly the cardiac and vascular diameters. The cardiac meridians include the right ventricular short axis maximum diameter (right ventricular short axis diameter, RVd), left ventricular short axis maximum diameter (left ventricular short axis diameter, LVd), right ventricular to left ventricular short axis maximum diameter ratio (RVd/LVd) and vascular diameters include the main pulmonary artery diameter (main pulmonary artery diameter, MPA), superior vena cava diameter (superior vena cava diameter, SVC). According to the CT pulmonary embolism index (PAOI),) of 54 patients with APE, according to PA0I30%,30% 鈮，
本文编号：2265757
[Abstract]:[objective] to investigate the evaluation of right ventricular function by CT pulmonary embolism index (pulmonary artery obstruction index, PAOI) in patients with acute pulmonary embolism (acute pulmonary embolism, APE) by analyzing CT pulmonary angiography (CTpulmonary angiography, CTPA), echocardiography (Echocardiography) (ultrasound cardiogram, UCG) and blood gas analysis (BGE) in patients with acute pulmonary embolism (acute pulmonary embolism, APE). [methods] from December 2011 to December 2012, Department of Respiratory, second affiliated Hospital of Kunming Medical University, were examined by (computed tomography, CT), blood gas analysis and echocardiography. There were 54 cases of PE, diagnosed by CTPA as having no serious basic cardiopulmonary disease and no active bleeding, no anticoagulant therapy and no definite history of chronic thromboembolic disease in the near future. The blood gas analysis of CTPA and UCG, in 54 patients with APE was analyzed. The CT occlusion index was calculated by using the score method designed by Qanadli et al, and the right cardiac function parameters were measured by CT, mainly the cardiac and vascular diameters. The cardiac meridians include the right ventricular short axis maximum diameter (right ventricular short axis diameter, RVd), left ventricular short axis maximum diameter (left ventricular short axis diameter, LVd), right ventricular to left ventricular short axis maximum diameter ratio (RVd/LVd) and vascular diameters include the main pulmonary artery diameter (main pulmonary artery diameter, MPA), superior vena cava diameter (superior vena cava diameter, SVC). According to the CT pulmonary embolism index (PAOI),) of 54 patients with APE, according to PA0I30%,30% 鈮，
本文编号：2265757
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