急性肺动脉栓塞患者心脏形态学变化与CT栓塞指数相关性研究  

Study on the correlation of cardiac morphological changes and CT obstruction index in patients with acute pulmonary embolism

作　　者：郭志军[1] 刘海涛[1] 曾艳红[1] 周海涛[1] 崔继岩 蔺强[1] GUO Zhijun;LIU Haitao;ZENG Yanhong;ZHOU Haitao;CUI Jiyan;LIN Qiang(Department of Radiology,North China Petroleum Administration Bureau General Hospital,Renqiu,Hebei Province 062552,China)

机构地区：[1]华北石油管理局总医院医学影像科,河北任丘062552

出　　处：《实用放射学杂志》2018年第9期1354-1358,共5页Journal of Practical Radiology

摘　　要：目的 通过急性肺动脉栓塞（APE）患者心脏CT测量参数与肺动脉阻塞指数（POI）之间的相关性分析，探讨APE患者心脏形态学变化规律。方法 118例APE患者，首先根据Qanadli评分法分为C组47例（POI≥20）与B组71例（POI＜20），并与60例对照组（A组）进行对比心脏CT各测量参数。其次，在APE心脏CT各测量参数与POI之间进行相关性分析。结果 除左心室前后径（AP）与右心房AP外，3组间比较有统计学意义（P＜0.05），APE患者右心增大（A组＜B组＜C组），左心缩小（A组＞B组＞C组）。左心室左右径（LR）值，A组＞B组（P＜0.05）。右心与左心径线各比值，3组间比较均有统计学意义，A组＜B组＜C组（P＜0.05）。118例PE患者POI 14.29±9.53，与各心腔测量参数之间相关性分析，除左心室AP与右心房AP外，均存在较明显相关性（P＜0.05），其中与右心房LR、右心室LR、LR两房比、LR两室比的相关系数达到0.5以上。结论 随着POI增大，APE患者右房、右室扩大，左房、左室缩小，并可以利用CT肺动脉造影（CTPA），甚至非增强胸部CT进行观测。Objective To analyze the correlation of cardiac CT measurement parameters and pulmonary obstruction index（POI） in acute pulmonary embolism （APE） patients to discuss the morphological cfianges of the heart of APE patients.Methods 118 cases of APE patients were divided into 2 groups, group C （47 cases, POI≥20） and group B （71 cases, POI〈20 ） according to the Qanadli score. Each measured cardiac parameter by CT was compared among group C, group B and the normal group （group A, 60 cases}. Then the correlation between the measured cardiac parameters by CT and the POI was analyzed.Results Except for the left ventricular AP diameter and the right atrial AP diameter,there were statistically significant differences （P〈0.05）.The right hearts were enlarged in APE patients （group A〈group B〈group C） ,and the left hearts were decreased in size （group A〉group B〉group C） and the LR diameter of the left ventricular （group A〉group B,P〈0.05）.According to the ratio of right/left heart diameter,there were statistically differermes among the three groups,group A〈group B〈group C（P〈0.05}. The POI of 118 APE patients were 14.29±9.53.Except for the left ventricular AP diameter and the right atrial AP diameter,there was significant correlation between the measured cardiac parameters by CT and the POI（P〈0.05）. The correlation coefficient reached above 0.5 for the right atrial LR diameter, the right ventricular LR diameter, the ratio of right/left atrial diameter and the ratio of right/left ventricular diameter.Conclusion With the increasing of POI, the right atrium and right ventricular of APE patients are enlarged,and the left atrium and left ventricular are decreased in slze.These changes can be observed by using CTPA,even non-enhanced chest CT.

关 键 词：急性肺动脉栓塞 心脏 计算机体层成像 

分 类 号：R543.2[医药卫生—心血管疾病] R814.42[医药卫生—内科学]