CT肺动脉阻塞指数对肺栓塞治疗效果的定量评估  

The Value of CT Obstruction Index in Monitoring the Therapeutic Effect of Patients with Pulmonary Embolism

作　　者：袁梅[1] 刘许慧[1] 俞同福[1] 

机构地区：[1]南京医科大学第一附属医院放射科,210029

出　　处：《临床放射学杂志》2011年第4期504-507,共4页Journal of Clinical Radiology

摘　　要：目的评估Qanadli等提出的CT阻塞指数在定量分析肺动脉栓塞（pulmonary embolism,PE）患者治疗效果中的价值。资料与方法经多层螺旋CT血管成像（CTA）确诊、经溶栓或（及）抗凝治疗并治疗后以CTA随访的患者55例,随访时间为1~6周。治疗前后采用Qanadli栓塞指数评价PE程度,并采用Spearman等级相关系数评价其与临床指征（血氧饱和度及肺动脉压）恢复的相关性。结果 55例患者中,51例经溶栓或（及）抗凝治疗后临床指征明显改善,血氧饱和度由（83.52±4.461）%上升到（94.76±3.532）%（P〈0.001）,肺动脉压力由（31.17±5.892）mmHg（1 mmHg=0.133 kPa）下降至（19.83±4.804）mmHg（P〈0.001）;Qanadli栓塞指数从治疗前的（45.09±18.22）%降至治疗后的（10.86±10.29）%（P〈0.001）。4例临床指征改善不明显,Qanadli栓塞指数治疗前后差异无显著统计学意义（P=0.080）。治疗前后Qanadli栓塞指数与血氧饱和度、肺动脉压力的差异度均存在良好相关性（r值分别为0.934、0.813）。结论 Qanadli栓塞指数可准确用于PE治疗效果的定量评估,对临床治疗方案的制定有指导作用。Objective To quantitively evaluate the value of computed tomography（CT）obstruction index described by Qanadli et al in monitoring the effect of pulmonary embolism（PE）treated by thrombolysis and（or） anticoagulation.Materials and Methods Fifty-five consecutive patient with PE by computed tomography angiography（CTA）at the initial time（T0）were selected.All patients were treated with thrombolysis and（or）anticoagulation.CTA was performed again as the follow-up evaluation（T1）with the mean interval time 1-6 weeks after therapy.Qanadli obstruction index was calculated at both T0 and T1.Therapeutic effect was evaluated with oxygen saturation（Sat.O2）and pulmonary artery pressure（PAP）using spearman method.Results The improvements of Sat.O2 and PAP immediately occurred in 51 of 55 patients after thrombolysis and（or）anticoagulation therapy.Qanadli obstruction index in the 51 patients decreased from（45.09±18.22）% to（10.86±10.29）% at T0 and T1 respectively with statistically significant difference（P0.001）.No statistical significant difference of Qanadli obstruction index between T0 and T1（P=0.080）was found in the rest four patients without improvement of Sat.O2 and PAP.Significant correlations existed between Qanadli obstruction index and Sat.O2（r=0.934）,as well as CT obstruction index and PAP（r=0.813）.Conclusion Qanadli obstruction index is an accurate,convenient and repeatable tool in quantitively evaluating therapeutic effects of pulmonary embolism（PE）with management of thrombolysis and（or）anticoagulation.

关 键 词：肺栓塞 栓塞指数 体层摄影术 X线计算机 血管造影术 

分 类 号：R563.5[医药卫生—呼吸系统]