肺灌注缺损指数和栓塞指数及右心功能参数对肺栓塞严重程度评价的研究  

Pulmonary perfusion defect index, pulmonary artery obstruction index and right heart function parameters for evaluating the severity of pulmonary embolism

作　　者：朱王维 朱佩云 李旭 韩云冲 刘虎 赵宏伟 Zhu Wangwei;Zhu Peiyun;Li Xu;Han Yunchong;Liu Hu;Zhao Hongwei(Department of Radiology,The Second Hospital of Jiaxing,Jiaxing 314000,Zhejiang Province,China)

机构地区：[1]嘉兴市第二医院放射科,嘉兴314000

出　　处：《中国基层医药》2022年第10期1501-1505,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省嘉兴市科技局民生科技创新研究项目 (2020AD30118)。

摘　　要：目的探讨肺灌注缺损指数(PPDI)和肺动脉栓塞指数(PAOI)及右心功能参数对肺栓塞严重程度的评估价值。方法回顾性分析嘉兴市第二医院2019年1月至2021年6月诊治的肺栓塞患者108例的临床资料,根据肺栓塞严重程度分为高危组(n=25)、中危组(n=32)、低危组(n=51),观察PAOI、PPDI、右心室短轴最大径(RV)、左心室短轴最大径比值(LV)、右/左心室短轴最大径比值(RV/LV),分析PPDI、PAOI、右心功能参数与肺栓塞严重程度的相关性,评估PPDI、PAOI、RV、LV、RV/LV、5项联合预测肺栓塞严重程度的曲线下面积(AUC)值、敏感度、特异度。结果高危组PPDI[(32.52±10.85)%]、PAOI[(45.01±15.02)%]、RV[(50.32±12.32)mm]、RV/LV(1.42±0.45)均高于低危组的(5.32±1.85)%、(12.52±3.25)%、(37.25±8.52)mm、(0.96±0.21),而LV[(35.14±10.52)mm]低于低危组的(44.02±15.21)mm(t=13.95、11.91、2.62、6.09、5.44,均P<0.05);中危组PPDI[(18.62±6.02)%]、PAOI[(28.65±8.65)%]、RV[(45.85±10.02)mm]、RV/LV(1.20±0.32)均高于低危组(t=14.75、12.06、4.18、4.13,均P<0.05)。中危组LV与低危组相比,差异无统计学意义(t=1.51,P>0.05)。Spearman相关性分析显示,PPDI、PAOI、RV、RV/LV与肺栓塞的严重程度呈正相关(r=0.87、0.84、0.45、0.41,均P<0.001);LV与肺栓塞严重程度呈负相关(r=-0.27,P<0.001)。受试者工作特征曲线(ROC曲线)分析显示,PPDI、PAOI、RV、LV、RV/LV、5项联合预测肺栓塞严重程度的AUC分别为0.941、0.911、0.721、0.693、0.726、0.951(均P<0.001)。结论PPDI、PAOI、右心功能参数可作为动态监测肺栓塞严重程度的有效指标。Objective To investigate the value of pulmonary perfusion defect index(PPDI),pulmonary artery obstruction index(PAOI)and right heart function parameters in the evaluation of severity of pulmonary embolism.Methods The clinical data of 108 patients with pulmonary embolism who received treatment in The Second Hospital of Jiaxing from January 2019 to June 2021 were retrospectively analyzed.These patients were divided into high-risk(n=25),moderate-risk(n=32),and low-risk(n=51)groups according to the severity of pulmonary embolism.PAOI,PPDI,right ventricular short axis maximum diameter(RV),left ventricular short axis maximum diameter(LV),ratio of right/left right ventricular short axis maximum diameter(RV/LV)were determined in each group.PPDI,PAOI and right ventricular function parameters were correlated with the severity of pulmonary embolism.The area under the receiver operating characteristic curve,specificity and severity of PPDI,PAOI,RV,LV,RV/LV used alone and in combination to predict the severity of pulmonary embolism were analyzed.Results PPDI,PAOI,RV,and RV/LV in the high-risk group were(32.52±10.85)%,(45.01±15.02)%,(50.32±12.32)mm,(1.42±0.45),respectively,which were significantly lower than(5.32±1.85)%,(12.52±3.25)%,(37.25±8.52)mm,(0.96±0.21)in the low-risk group,and LV was significantly lower in the high-risk group than that in the low-risk group[(35.14±10.52)mm vs.(44.02±15.21)mm,t=13.95,11.91,2.62,6.09,5.44,all P<0.05].PPDI,PAOI,RV,and RV/LV in the moderate-risk group were(18.62±6.02)%,(28.65±8.65)%,(45.85±10.02)mm,and(1.20±0.32),respectively,which were significantly higher than those in the low-risk group(t=14.75,12.06,4.18,4.13,all P<0.05).There was no significant difference in LV between moderate-risk and low-risk groups(t=1.51,P>0.05).Spearman correlation analysis showed that PPDI,PAOI,RV,RV/LV were positively correlated with the severity of pulmonary embolism(r=0.87,0.84,0.45,0.41,all P<0.001).LV was negatively correlated with the severity of pulmonary embolism(r=-0.27,P<0.001).The recei

关 键 词：脉栓塞指数 肺灌注缺损指数 右心室短轴最大径 左心室短轴最大径比值 右心功能 肺栓塞 高危 中危 低危 

分 类 号：R563.5[医药卫生—呼吸系统]