基于胸部X线的定量分析在高原肺水肿治疗前后中的对比研究  

A comparative study on high-altitude pulmonary edema pre-and post-treatment:a quantitative analysis based on chest X-ray

作　　者：张卫善[1,2] 卓嘎拉姆 王斐 颜格[1] 巴桑旺拉 普布占堆 杨健 ZHANG Weishan;Dolkar Lhamo;WANG Fei;YAN Ge;Pasang Wanlha;Phurbu Zhandui;YANG Jian(Department of Radiology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Radiology,the Tibetan Ali People's Hospital,Ali,Tibet 859000,China)

机构地区：[1]西安交通大学第一附属医院影像科,陕西西安710061 [2]西藏阿里地区人民医院放射科,西藏阿里859000

出　　处：《实用放射学杂志》2019年第12期1918-1921,共4页Journal of Practical Radiology

摘　　要：目的探讨基于胸部X线的定量分析方法在高原肺水肿(HAPE)治疗前后对比中的临床价值。方法连续性纳入HAPE患者63例。分别对患者入院时及治疗后胸部X线片进行分析,根据疾病的严重程度及病变分布范围对HAPE进行评分(SHAPE),测量并计算心胸比(CTR)和主肺动脉面积(AMPA)。治疗前后对比采用配对t检验,治疗后SHAPE的降低与主肺动脉(MPA)的缩小进行Pearson相关分析,P<0.05为差异有统计学意义。结果HAPE治疗后胸部X线片显示病变吸收,SHAPE、AMPA和CTR较入院时均缩小。治疗前SHAPE、AMPA及CTR分别为10.1、7.4 cm2及0.51,治疗后分别降至2.8、5.0 cm^2及0.48,组间差异有统计学意义(P<0.001)。治疗后SHAPE的降低与AMPE的缩小有中度相关性(r=0.649,P<0.001)。结论基于胸部X线的定量分析方法有利于对治疗前后HAPE患者的病情评估。Objective To explore the clinical value of quantitative analysis method based on chest X-ray in the comparison of highaltitude pulmonary edema(HAPE)pre-treatment and post-treatment.Methods 63 patients with HAPE were consecutively enrolled.Analyzing the radiographs before and after treatment respectively,the HAPE was scored(SHAPE)according to the severity and distribution of the disease,meanwhile,the cardiothoracic ratio(CTR)and the area of main pulmonary artery(AMPA)were measured and calculated.Paired Z-test was used before and after treatment.The decrease of Shape and the reduction of MPA after treatment were made by Pearson correlation analysis.P<0.05 was considered statistically significant.Results Radiographs showed lesion absorption after the treatment of high altitude pulmonary edema,and the Shape,Ampa and CTR were all reduced compared with in admission.SHAPE,AMPA and CTR were 10.1,7.4 cm2 and 0.51 before treatment,respectively;and decreased to 2.8,5.0 cm2 and 0.48 after treatment.lt was statistically significant in difference between the groups(P<0.001).The decrease of Shape after treatment were moderately correlated with the reduction of Ampa(r=0.649,P<0.001).Conclusion Quantitative analysis method based on chest X-ray is helpful to evaluate the condition of patients with HAPE before and after treatment.

关 键 词：高原肺水肿 肺动脉高压 胸部X线摄影 定量分析 

分 类 号：R563[医药卫生—呼吸系统] R543.2[医药卫生—内科学]