CTPA对急性肺动脉栓塞程度及疗效的评价  

CTPA in evaluating the degree of acute pulmonary obstruction and effect of treatment

作　　者：周欣[1] 武志峰[2] 周旭 

机构地区：[1]山西医科大学,山西太原030001 [2]山西医科大学第一医院CT室,山西太原030001 [3]陕西省咸阳市三原县新中医院CT室,陕西咸阳713800

出　　处：《中国临床医学影像杂志》2011年第7期468-471,共4页Journal of China Clinic Medical Imaging

基　　金：国家十一五科技支撑计划项目(2006BAI01A06)

摘　　要：目的:探讨CT肺血管造影(CTPA)对急性肺栓塞患者的栓塞程度及治疗前后右心功能参数变化评价的价值。方法:收集临床疑诊肺栓塞病例152例,纳入118例,所有病例均行CTPA检查,其中40例为非肺栓塞(WPE组),肺动脉栓塞患者78例,后者结合临床表现分为严重栓塞42例(SPE组),非严重栓塞36例(NSPE组)。SPE组立即行溶栓治疗,NSPE组则行抗凝治疗,于治疗14天后行CTPA复查。以CTPA作为肺栓塞的诊断依据,分析3组之间的心血管参数的差异;分析SPE组与NSPE组的栓塞指数,并探讨其与心血管参数之间的相关性;分析肺栓塞组治疗前后的心血管参数的差异。结果:SPE组的阻塞指数高于NSPE组;对心血管的参数分析发现,WPE组与栓塞组之间有显著性差异,SPE组与NSPE组之间亦有显著性差异。阻塞指数和心血管参数之间的相关性有统计学意义,其中右肺动脉管径与阻塞指数之间的相关系数最高。SPE组与NSPE组治疗前后的心血管参数均有统计学差异。结论:CTPA不仅可以诊断肺动脉栓塞,还可以反映肺栓塞后肺动脉的阻塞程度和右心功能的改变,从而反映预后,且可以观察疗效。Objective：To explore the value of CTPA in grading the severity of acute pulmonary embolism（PE） and to investigate the change of the cardiovascular parameters before and after treatment.Method：152 cases of clinical suspicion of PE,included 118 cases explored by CTPA were studied.The patients were separated into three different groups according to clinical severity and treatment decision：included patients without PE（WPE）（n=40）;included patients with severe PE（group SPE） who were treated by fibrinolysis（n=42）;and included patients with non-severe PE（group NSPE） who received heparin（n=36）;then reviewed the results of CTPA after the treatment of 14 days.With the diagnosis of CTPA as a basis,we analyzed the difference of cardiovascular parameters among the three groups;analyzed the obstruction index between group SPE and group NSPE,the correlation between obstruction index and cardiovascular parameters;explored the difference of cardiovascular parameters before and after treatment for PE.Result：CT obstruction index in patients with SPE was higher than that of patients with NSPE.The cardiovascular parameters in patients of the three groups,showed significant difference.The correlation between CT obstruction indexes and cardiovascular parameters was significant.Spearman＇s rank correlation coefficent was higher between right pulmonary artery diameter and CT obstruction index.The cardiovascular parameters between patients with group SPE and group NSPE before and after treatment showed significant difference.Conclusion：CTPA not only can diagnose PE also can evaluate the degree of pulmonary arterial obstruction and the change of right heart function,and then reflect the prognosis and observe curative effect.

关 键 词：肺栓塞 心室功能 右 体层摄影术 螺旋计算机 

分 类 号：R563.5[医药卫生—呼吸系统] R814.42[医药卫生—内科学]