肺癌合并肺栓塞CT肺动脉造影表现、凝血及纤溶指标分析  

Pulmonary embolism complicated lung cancer:CT pulmonary angiography and coagulation and fibrinolysis indexs

作　　者：火忠[1] 王英颖 巴图尔·吐尔地[1] HUO Zhong;WANG Yingying;BATUER·Tuerdi(Department of Radiology,the People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院放射科,新疆乌鲁木齐830001

出　　处：《实用放射学杂志》2020年第4期563-566,共4页Journal of Practical Radiology

摘　　要：目的分析肺癌合并肺栓塞患者的CT肺动脉造影(CTPA)的影像表现及凝血和纤溶指标.方法选取经CTPA诊断的肺栓塞患者82例,其中通过病检证实的32例肺癌合并肺栓塞患者为肺癌组,50例无恶性肿瘤病史的肺栓塞患者为非肿瘤组.对比2组的肺栓塞的分布种类、栓塞程度、肺动脉直径、肺栓塞的间接表现.统计肺癌组肺栓塞发生的时间、肺癌病理类型及有无转移等资料.分析2组的凝血和纤溶指标.结果肺癌合并肺栓塞的发病率为39%(32/82),肺癌中腺癌占50%(16/32).CTPA检查发现肺癌组中央性肺栓塞、肺内渗出性病灶和胸腔积液的发生率均高于非肿瘤组(P<0.05).动脉栓塞分布类型、肺动脉直径及栓塞面积,2组之间无统计学差异.2组凝血指标无统计学意义.肺癌组纤溶指标D-二聚体显著高于非肿瘤组.结论CTPA可显示肺癌合并肺栓塞的一些影像学特征.结合检测D-聚体提供纤溶程度可引导临床治疗.Objective To analyze the image manifestations of CT pulmonary angiography(CTPA),coagulation and fibrinolysis index in lung cancer with pulmonary embolism.Methods 82 cases with pulmonary embolism diagnosed by CTPA were collected.There were divided into the lung cancer group(32 cases of lung cancer confirmed by pathology)and the non-tumor group(50 cases without malignant tumor history).The distribution,degree,diameter and indirect manifestations of pulmonary embolism were ana-lyzed and compared between the two groups.The occurrence time of pulmonary embolism,pathological types and metastasis in lung cancer group were analyzed.The coagulation index and fibrinolysis index of the two groups were analyzed.Results The incidence of lung cancer with pulmonary embolism was 39%(32/82),and was 50%in the adenocarcinomas(16/32).CTPA showed that the inci-dence of central pulmonary embolism,exudative pulmonary lesions and pleural effusion were higher in the lung cancer group than in the non-tumor group(P<0.05).There were no significant differences in distribution type,diameter of pulmonary artery and area of pulmonary embolism between the two groups.There were no significant differences in the coagulation index between the two groups.ITdimer was significantly higher in the lung cancer group than in the non-tumor group.Conclusion CTPA can show some imaging features of lung cancer with pulmonary embolism.Combined with the detection of D-dimer to provide the degree of fibrinolysis can guide the clinical treatment.

关 键 词：肺癌 肺栓塞 CT肺血管造影 D-二聚体 

分 类 号：R734.2[医药卫生—肿瘤] R563.5[医药卫生—临床医学]