三尖瓣环收缩期位移与肺动脉阻塞指数对高原地区肺栓塞的评估价值  

Evaluation of the value of the Tricuspid annulus plane systolic excursion and pulmonary artery CT obstruction index on the severity of acute pulmonary embolism in the plateau region

作　　者：史建玲[1] 沈亚 刘海鹏[2] 银武[2] 张一休[3] SHI Jianling;SHEN Ya;LIU Haipeng;YIN Wu;ZHANG Yixiu(University of Tibet Medical School, Lhasa 850000, P.R.China;Department of Radiology, Tibet Autonomous Region People's Hospital, Lhasa 850000, P.R.China;Department of Ultrasound, Peking Union Medical College Hospital, Beijing 100000, P.R.China)

机构地区：[1]西藏大学医学院,西藏拉萨850000 [2]西藏自治区人民医院影像科,西藏拉萨850000 [3]中国医学科学院北京协和医院超声医学科,北京100730

出　　处：《医学影像学杂志》2021年第12期2039-2042,共4页Journal of Medical Imaging

摘　　要：目的超声心动图三尖瓣环收缩期位移及CT Qanadli肺动脉栓塞指数与常规指标相对照,探讨其对高原地区肺栓塞严重性的评估价值。方法选取2016年10月~2017年8月经西藏自治区人民医院呼吸内科诊断的急性肺栓塞患者33例。所有患者均行CT肺血管造影检查,计算Qanadli栓塞指数并测量右心室/左心室横径比、右心房/左心房面积比;CT肺血管造影检查后行经胸超声心动图检查,测量三尖瓣环收缩期位移,右心室/左心室横径比,并估测肺动脉收缩压。根据简化肺栓塞严重性指数将其分为高危组与低危组,比较两组间的超声心动图与CTPA参数。结果两组间超声心动图参数三尖瓣环收缩期位移(P=0.00)、右心室/左心室横径比(P=0.03)、肺动脉收缩压(P=0.02)差异均有统计学意义,两组间CT肺血管造影参数Qanadli栓塞指数(P=0.04)、右心室/左心室横径比(P=0.02)差异有统计学意义。结论三尖瓣环收缩期位移对高原急性肺栓塞的严重性有较好的评估价值。Objective To explore the value of the Tricuspid annulus plane systolic excursion and CT Qanadli obstruction index on the severity of pulmonary embolism in the plateau region.Methods Thirty-three acute pulmonary embolism patients diagnosed in the pneumology department of the tibet autonomous region people's hospital between october 2016 and August 2017 were included in this prospective study.All patients were examined by CT pulmonary artery angiography.We calculated the qanadli obstruction index and measured right ventricle/left ventricle short-axis diameter ratio and right atrial/left atrial area ratio.Transthoracic echocardiography was performed within 48 hours after CT examination.We measured the tricuspid annulus plane systolic excursion,right ventricular/left ventricular short-axis diameter ratio and estimated pulmonary artery systolic pressure.All patients were divided into two groups according to the sPESI.All image parameters were examined by the Mann-Whitney U test.Results There was a statistically significant difference in TAPSE(P=0.00),RV/LV(P=0.03),PASP(P=0.02)of transthoracic echocardiography parameters between two groups,and the statistically significant difference was found in the qanadli obstruction index(P=0.04),RV/LV(P=0.02)of CT parameters between two groups.Conclusion The TAPSE is preferable to other TTE and CT parameters for risk stratification in plateau region patients with APE.

关 键 词：急性肺栓塞 超声心动图描记术 三尖瓣环收缩期位移 体层摄影术 X线计算机 

分 类 号：R563.5[医药卫生—呼吸系统] R445.1[医药卫生—内科学]