超声心动图参数指标诊断急性加重期慢性阻塞性肺病伴发肺栓塞严重程度的价值分析  

Value of echocardiographic parameters in diagnosing the severity of acute exacerbation of chronic obstructive pulmonary disease complicated with pulmonary embolism

作　　者：葛豪爽 王一洒[2] 赵世勇 GE Haoshuang;WANG Yisa;ZHAO Shiyong(Department of Ultrasound,Henan Wujian Construction Group Co.,Ltd.Employee Hospital,Zhengzhou450000,China;Department of Ultrasound,Henan Provincial People's Hospital,Zhengzhou450003,China;Department of Ultrasound,Henan Provincial Thoracic Hospital,Zhengzhou450003,China)

机构地区：[1]河南五建建设集团有限公司职工医院超声科,河南郑州450000 [2]河南省人民医院超声科,河南郑州450003 [3]河南省胸科医院超声科,河南郑州450003

出　　处：《社区医学杂志》2023年第15期769-773,共5页Journal Of Community Medicine

摘　　要：目的探讨超声心动图参数指标诊断急性加重期慢性阻塞性肺病(AECOPD)伴发肺栓塞严重程度的价值,为制定相应干预措施提供参考依据。方法选取2019-08-01-2021-08-31河南五建建设集团有限公司职工医院收治的75例AECOPD伴发肺栓塞患者设为研究组,根据肺栓塞严重程度指数(PESI)分为轻度(n=48)和重度亚组(n=27);另选择150例同期的单纯AECOPD患者设为参照组。患者入院后均行超声心动图检查,比较研究组和参照组、研究组轻度和重度患者超声心动图参数指标〔肺动脉主干直径(PA)、肺动脉瓣口前向的血流速度(PV)、右心室的前后径(RV)、三尖瓣口舒张末期的峰值速度(Am)、三尖瓣口舒张早期的峰值速度(Em)〕,并分析超声心动图各参数指标PA、RV、PV、Em、Am与PESI评分的相关性,分析超声心动图各参数指标PA、RV、PV、Em、Am联合诊断AECOPD伴发肺栓塞的价值。结果研究组PA、RV、Am分别为(29.84±2.15)mm、(27.84±2.63)mm、(13.85±1.67)cm/s,高于参照组的(22.36±1.93)mm、(21.58±2.28)mm、(10.25±1.29)cm/s,PV、Em分别为(0.32±0.13)m/s、(8.23±1.54)cm/s,低于参照组的(0.69±0.18)m/s、(13.85±2.84)cm/s,差异有统计学意义,t值分别为26.371、18.429、17.834、15.847和145.991,均P<0.001;研究组重度组患者PA、RV、Am分别为(35.16±3.85)mm、(33.55±3.28)mm、(16.46±2.37)cm/s,高于轻度组的(26.85±3.24)mm、(24.63±2.56)mm、(12.38±2.16)cm/s,PV、Em分别为(0.21±0.06)m/s、(6.65±1.37)cm/s,低于轻度组的(0.38±0.12)m/s、(9.12±2.24)cm/s,差异有统计学意义,t值分别为9.956、13.068、7.582、6.879和7.582,均P<0.001;PA、RV、Am与PESI评分呈正相关,(r值分别为0.712、0.728和0.658,均P<0.001),PV、Em与PESI评分呈负相关,r值分别为-0.753和-0.695,均P<0.001;PA、RV、PV、Em、Am诊断AECOPD伴发肺栓塞的AUC分别为0.795、0.759、0.737、0.811、0.846,联合诊断的AUC为0.927,联合诊断价值优于单一指标。结论超声心动图可用于�Objective To explore the value of echocardiographic parameters in diagnosing the severity of pulmonary embolism in acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to provide a reference for formulating corresponding intervention measures.Methods Totally 75patients with AECOPD complicated with pulmonary embolism admitted to Henan Wujian Construction Group Co.,Ltd.Employee Hospital from August 1,2019to August 31,2021were selected as the study group,and they were divided into mild(n=48)and severe subgroups(n=27)according to the pulmonary embolism severity index(PESI);another 150patients with simple AECOPD in the same period were selected as the reference group.All patients were examined by echocardiography after admission.The parameters of echocardiography[pulmonary artery main diameter(PA),pulmonary valve orifice forward flow velocity(PV),right ventricular anteroposterior diameter(RV),tricuspid valve end diastolic peak velocity(Am),tricuspid valve early diastolic peak velocity(Em)]were compared between the study group and the reference group,mild and severe patients in the the study group;the correlation of PA,RV,PV,Em,Am with the PESI score was analyzed,and the value of combined diagnosis of PA,RV,PV,Em and Am in AECOPD complicated with pulmonary embolism was analyzed.Results The PA,RV,and Am of the study group were(29.84±2.15)mm,(27.84±2.63)mm,and(13.85±1.67)cm/s,respectively,which were higher than those in the reference group(22.36±1.93)mm,(21.58±2.28)mm,and(10.25±1.29)cm/s,while PV and Em were(0.32±0.13)m/s and(8.23±1.54)cm/s,respectively,which were lower than those in the reference group(0.69±0.18)m/s and(13.85±2.84)cm/s,the difference was statistically significant(t=26.371,18.429,17.834,15.847,145.991,all P<0.001);the PA,RV,and Am of patients in the severe group were(35.16±3.85)mm,(33.55±3.28)mm,and(16.46±2.37)cm/s,respectively,which were higher than those in the mild group(26.85±3.24)mm,(24.63±2.56)mm,and(12.38±2.16)cm/s,while the PV and Em were(0.21±0.06)m/s,(6.65±1

关 键 词：超声心动图 慢性阻塞性肺病 肺栓塞 诊断价值 

分 类 号：R563.5[医药卫生—呼吸系统]