摘要
目的探讨阻塞性肺疾病(COPD)合并肺心病患者临床特点及多层螺旋CT(MSCT)影像诊断价值。方法选取本院2018年12月至2019年12月150例COPD患者,其中单纯COPD患者91例,COPD合并肺心病患者59例,另选取同期本院无心肺疾病史的健康体检者30例作为正常对照组,所有纳入对象均通过MSCT检查,分析COPD合并肺心病患者临床特点,记录右心室功能参数,分析各参数疾病诊断价值。结果COPD合并肺心病患者胸痛、双下肢浮肿症状比例高于单纯COPD患者,肢体导联低电压、电轴顺钟向转位、右心室肥大、房性早搏心电图表现比例高于单纯COPD患者(P﹤0.05);COPD合并肺心病患者舒张末容积(EDV)、每搏输出量(SV)、射血分数(EF)水平低于单纯COPD患者,单纯COPD患者低于健康对照患者(P﹤0.05);三组收缩末容积(ESV)水平比较(P﹥0.05);EDV、SV及EF联合检测鉴别单纯COPD与无COPD ROC曲线下面积为0.887高于单独检测0.807、0.789、0.778,鉴别单纯COPD与COPD合并肺心病ROC曲线下面积为0.912高于单独检测0.798、0.800、0.775(P﹤0.05)。结论COPD合并肺心病患者EDV、SV、EF水平相对于单纯COPD患者水平较低,MSCT检测适用于临床COPD合并慢性肺心病的诊断。
Objective To explore the clinical features and diagnostic value of multi-slice spiral computed tomography(MSCT)in patients with chronic obstructive pulmonary disease(COPD)and chronic pulmonary heart disease(CPHD).Methods A total of 150 COPD patients in the hospital from December 2018 to December 2019 were enrolled,including 91 cases with simple COPD and 59 cases with COPD and CPHD.Another 30 healthy controls without cardiopulmonary diseases history in the hospital during the same period were enrolled as normal control group.All underwent MSCT examination.The clinical features of patients with COPD and CPHD were analyzed.The right ventricular function parameters were recorded.The diagnostic value of each parameter for COPD combined with CPHD was analyzed.Results The proportion of cases with chest pain and lower extremities edema in patients with COPD and CPHD was higher than that with simple COPD,and proportion of cases with electrocardiogram findings(low limb lead voltage,clockwise rotation of electrical axis,right ventricular hypertrophy,atrial premature beats)was higher than that with simple COPD(P﹤0.05).The levels of end-diastolic volume(EDV),stroke volume(SV)and ejection fraction(EF)were the highest in healthy controls,followed by patients with simple COPD and those with COPD and CPHD(P﹤0.05).There was no significant difference in level of end-systolic volume(ESV)among the three groups(P﹥0.05).The area under the ROC curve(AUC)of EDV combined with SV and EF for distinguish simple COPD from non-COPD was higher than that of single index(0.887 vs 0.807,0.789,0.778),and AUC for distinguishing simple COPD from COPD combined with CPHD was higher than that of single index(0.912vs 0.798,0.800,0.775)(P﹤0.05).Conclusion The levels of EDV,SV and EF in patients with COPD and CPHD are lower than those with COPD alone.MSCT detection is suitable for clinical diagnosis of COPD combined with CPHD.
作者
韩春杰
HAN Chun-jie(Department of Medical Imaging,Tibet Armed Police Corps Hospital,Lhasa 850000,Tibet,China)
出处
《中国CT和MRI杂志》
2022年第11期58-60,共3页
Chinese Journal of CT and MRI
关键词
慢性阻塞性肺疾病
慢性肺源性心脏病
临床特点
多层螺旋CT
诊断价值
Chronic Obstructive Pulmonary Disease
Chronic Pulmonary Heart Disease
Clinical Feature
Multi-Slice Spiral CT
Diagnostic Value
作者简介
第一作者/通讯作者:韩春杰,男,主治医师,主要研究方向:CT诊断腹腔结核、泌尿系统结核、肺心病等。E-mail:tongnian0202@163.com。
