摘要
目的:探讨多层螺旋CT右心功能参数对急性肺栓塞患者的评估价值,以期为临床早期评估右心功能、栓塞程度提供参考。方法:选取我院2020年1月至2022年4月就诊的66例急性肺栓塞患者作为研究组,根据其早期死亡风险分为高危组(n=32)和非高危组(n=34),另选取50例同期健康体检者为参照组,入院后均行多层螺旋CT检查测定患者右心功能参数,包括右心室短轴最大直径(Right ventricular maximal short axis,RVMSA)、左心室短轴最大直径(Left ventricular maximal short axis,LVMSA)、右心室、左心室短轴最大直径的比值(RV︰LV)、主肺动脉直径、奇静脉直径;并比较高危组、非高危组CT阻塞评分、指数,分析CT右心功能参数与急性肺栓塞阻塞程度相关性,采用受试者工作特征(Receiver operating character,ROC)及曲线下面积分析其对急性肺栓塞病情诊断价值。结果:与参照组比较,研究组RVMSA、RV︰LV、主肺动脉直径、奇静脉直径较大,LVMSA较小(P<0.05);与非高危组比较,高危组RVMSA、RV︰LV、主肺动脉直径、奇静脉直径较大,LVMSA较小(P<0.05);与非高危组比较,高危组CT阻塞评分、指数较高(P<0.05);RVMSA、RV︰LV、主肺动脉直径、奇静脉直径与CT阻塞评分、指数呈正相关,LVMSA与CT阻塞评分、指数呈负相关(P<0.05);RVMSA、LVMSA、RV︰LV、主肺动脉直径、奇静脉直径对急性肺栓塞病情诊断AUC分别为0.795、0.832、0.822、0.798、0.856,联合诊断AUC为0.927。结论:多层螺旋CT右心功能参数对于急性肺栓塞患者右心功能、栓塞程度具有较高评估价值,临床可通过其进行早期病情评估,以针对性制定治疗方案。
Objective:To investigate the value of multilayer spiral CT right heart function parameters in the assessment of patients with acute pulmonary embolism,to provide a reference for the early clinical assessment of right heart function and the degree of embolism.Methods:Sixty-six patients with acute pulmonary embolism seen in our hospital from January 2020 to April 2022 were selected as the study group and were divided into a high-risk group(n=32)and a non-high-risk group(n=34)according to their risk of early death,and 50 patients who had a healthy physical examination at the same time were selected as the reference group.Right ventricular maximal short axis(RVMSA),left ventricular maximal short axis(LVMSA),the ratio of right ventricular to left ventricular maximal short axis(RV:LV),main pulmonary artery diameter,and odd vein diameter were measured after admission.The CT obstruction score and index were compared between the high-risk and non-high-risk groups.The correlation between CT right heart functionparameters and the degree of obstruction in acute pulmonary embolism was analyzed,and its diagnostic value for acute pulmonary embolism condition was analyzed using Receiver operating character(ROC)and area under the curve.Results:RVMSA,RV:LV,main pulmonary artery diameter,and odd vein diameter were larger and LVMSA was smaller in the study group compared with the reference group(P<0.05).RVMSA,RV:LV,main pulmonary artery diameter,and odd vein diameter were larger and LVMSA was smaller in the high-risk group compared with the non-high-risk group(P<0.05).Higher CT obstruction scores and indices in the high-risk group compared to the non-high-risk group(P<0.05).RVMSA,RV:LV,main pulmonary artery diameter,and odd vein diameter were positivelycorrelated with CT obstruction score and index,and LVMSA was negatively correlated with CT obstruction score and index(P<0.05).The diagnostic AUCs for acute pulmonary embolism condition were 0.795,0.832,0.822,0.798,and 0.856 for RVMSA,LVMSA,RV:LV,main pulmonary artery diameter,and odd vein diameter,respectively,and 0.927 for the combined diagnosis.Conclusion:Multilayer spiral CT right heart function parameters have high value in assessing the right heart function and the degree of embolism in patients with acute pulmonary embolism,which can be used for early clinical assessment of the disease to target the treatment plan.
作者
朱园园
王健
李文娟
Zhu Yuan-yuan;Wang Jian;Li Wen-juan(Imaging Center,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China)
出处
《四川生理科学杂志》
2023年第9期1545-1548,共4页
Sichuan Journal of Physiological Sciences
基金
2019年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20190564)。
关键词
急性肺栓塞
多层螺旋CT
右心功能
阻塞程度
Acute pulmonary embolism
Multilayer spiral CT
Right heart function
Degree of obstruction
作者简介
朱园园,女,住院医师,主要从事肺栓塞患者CT评价,Email:r9C9zJ@163.com。
