CT测量肺动脉直径对COPD肺动脉高压的诊断价值  

Diagnosis Value of CT Pulmonary Artery Diameter for Pulmonary Hypertension in COPD

作　　者：贺俊斌 武洪林[1] 周燕娟[2] 朱燕[2] 武求花 龚波[1] 许建兴[1] 李红尧[1] 吴惠明[1] HE Jun-bin;WU Hong-lin;ZHOU Yan-juan(The Affiliated WujinHospital of Jiangsu University, Jiangsu 213002, China)

机构地区：[1]江苏大学附属武进医院影像科,213002 [2]江苏大学附属武进医院呼吸科,213002 [3]江苏大学附属武进医院心电学科,213002

出　　处：《心脑血管病防治》2018年第6期452-454,464,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：江苏大学医学临床科技发展基金项目(编号:JLY20120044);常州市武进区科技发展计划项目(编号:WS201115)

摘　　要：目的探讨胸部CT测量肺动脉直径在慢性阻塞性肺疾病(COPD)肺动脉高压(PH)诊断中的价值。方法回顾性分析92例COPD患者。所有患者接受胸部CT、肺功能及超声心动图检查。通过CT测量肺动脉(PA)和升主动脉(A)直径。计算PA及PA:A比值在诊断PH中的不同临界值。结果 92例COPD患者中,包括PH 43例,非PH 49例。PH组、非PH组主肺动脉直径分别为(30. 83±3. 82) mm、(25. 66±2. 54) mm,肺动脉与升主动脉直径比分别为(0. 99±0. 12)、(0. 84±0. 10),两者差异有统计学意义(P <0. 05)。PA:A≥1的阴性预测值78%,阳性预测值为94%。PA直径≥30mm的阴性预测值为77%,阳性预测值为64%。PA和PA:A比值与肺动脉收缩压(PASP)之间呈显著正相关(r=0. 73、0. 54,P <0. 01)。结论 PA及PA:A比值可作为筛查PH的指标。Objective To evaluate the diagnostic value of pulmo nary artery(PA)diameter measurements on chest CT for pulmonary hypertension(P H)in COPD.Methods92COPD patients were analyzed retrospectively,who reci eved chest CT,pulmonary function(PF)test,and echocardiography.Diameters of PA and ascending aorta(A)were measured by CT.Diagnostic properties of diffe rent cut-offs of PA diameter and PA:A ratio in diagnosing PH were calculated.Results Of92COPD patien ts,there were43cases with PH and49cases without PH.The PA diameter of pat ients with PH and without PH was respectively(30.83±3.82)mm and(25.66±2.54)mm on images.The ratio of PA:A was respectively(0.99±0.42)and(0.84±0.10).All the differences were statistically significant(P<0.05).PA:A≥1had a negative predictive value of78%and a positive predictive value of94%.PA diameter≥30mm had a negative predictive value of77%and p ositive predictive value of64%.The pulmonary artery systolic pressure(PASP)was positively correlated with the PA and the ratio of PA:A(r=0.73,P<0.01;r=0.54,P<0.01).Conclusions The PA diameter and the ratio of PA:A on CT scan can be used as screening index for PH.

关 键 词：慢性阻塞性肺疾病 肺动脉高压 肺功能试验 超声心动图 CT 

分 类 号：R563.4[医药卫生—呼吸系统] R816.41[医药卫生—内科学]