胸部CT主肺动脉比与血压的相关性及临床意义  

Correlation between diameter ratio of aorta to pulmonary and blood pressure with chest CT and its clinical significance

作　　者：魏淼[1] 温家华[1] 刘洋[1] 吴家会[1] 吕发金[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《中国医学影像技术》2015年第8期1216-1220,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家临床重点专科建设项目经费资助(国卫办医函[2013]544号)

摘　　要：目的探讨胸部CT主肺动脉比(RAP)与血压的相关性及临床意义。方法回顾性分析191例高血压患者(高血压组)及87名健康体检者(对照组)的胸部CT资料。高血压组根据血压升高情况分为T1组(1级高血压,63例)、T2组(2级高血压,60例)及T3组(3级高血压,68例),根据治疗情况分为A组(治疗组,94例)和B组(未治疗组,97例);结合血压和治疗情况,其中A1组31例、A2组30例、A3组33例,B1组32例、B2组30例、B3组35例。对照组根据年龄分为C1组(老年组,年龄≥60岁)40名及C2组(非老年组,年龄<60岁)47名。通过平扫轴位图像测量升主动脉、肺动脉直径,计算RAP。连续7天记录清晨稳定血压并取平均值作为临床血压检测结果,包括收缩压(SBP)及舒张压(DBP)。结合年龄、血压等级及治疗情况分组分析血压与RAP的相关性,并评价RAP对1级高血压的诊断效能。结果 T1、T2、T3、C1及C2组间两两比较,SBP及RAP差异均有统计学意义(P均<0.05),DBP差异均无统计学意义(P均>0.05)。A1、A2、A3、B1、B2及B3组间两两比较,升主动脉、肺动脉直径及RAP差异均有统计学意义(P均<0.05)。对照组、高血压组、A组、B组SBP均与RAP呈正相关(P均<0.05)。对照组及高血压组DBP与RAP均无相关性(P均>0.05)。以RAP=1.29为阈值,诊断1级高血压的敏感度为85.71%(54/63),特异度为89.66%(78/87),误诊率10.34%(9/87),漏诊率14.29%(9/63),Youden指数为0.75。结论胸部CT所测RAP可客观反映血压水平,RAP与SBP呈正相关。Objective To investigate the correlation between diameter ratio of aorta to pulmonary artery （RAP） and blood pressure and its clinical significance. Methods Chest CT images of 191 hypertension patients （hypertension group） and 87 healthy controls （control group） were retrospectively analyzed. According to hypertension grade of 1, 2 and 3, patients in hypertension group were divided into T1 （n=63）, T2 （n=60） and T3 （n=68） subgroups. According to treatment, pa- tients in hypertension group were divided into subgroup A （underwent treatment, n= 94） and subgroup B （without treat- ment , n=97）. Considering hypertension grade and treatment, there were in 31 cases in A1, 30 cases in A2, 33 cases in A3, 32 cases in B1, 30 cases in B2 and 35 cases in B3 subgroups. Cases in control group were divided into C1 （960 years, n=40） and C2 （〈60 years, n=47） subgroups according to age. Morning and steady blood pressures was recorded of 7 days continuously, and the mean value was calculate as clinical blood pressure result. Both of systolic blood pressure （SBP） and diastolic blood pressure （DBP） were detected. Correlation between RAP and blood pressure was studied with compre- hensive analysis of age, hypertension grade and treatment. And the diagnosis efficacy of RAP for grade 1 hypertension was evaluated. Results Among T1, T2, T3, C1 and C2 subgroups, statistical differences of SBP and RAP were found in mul- tiple comparison （all P〈0. 05）, and there was no statistical differences of DBP （all P〉0. 05）. Among A1, A2, A3, B1, B2 and B3 subgroups, there were statistical differences of ascending aorta and pulmonary artery diameters as well as RAP in multiple comparison （all P〈0.05）. SBP positively correlated with RAP in hypertension group, control group, subgroup A and subgroup B （all P〈0. 05）. No correlation was found between DBP and RAP in hypertension group and control group （all P〉0.05）. Taking 1.29 as the threshold of RAP in diagnosing grade 1 hyperten

关 键 词：胸部 体层摄影术 X线计算机 主肺动脉直径比 血压 

分 类 号：R814.42[医药卫生—影像医学与核医学] R3[医药卫生—放射医学]