多层螺旋计算机断层扫描多维重建参数、血管活性药物评分在急性主动脉夹层预后中的预测价值  

Predictive value of multi-slice spiral computed tomography multi-dimensional reconstruction parameters and vasoactive inotropic score in acute aortic dissection

作　　者：江昆[1] 郭建 薛才广 宋伟[1] Jiang Kun;Guo Jian;Xue Caiguang;Song Wei(Department of Cardiovascular and Macrovascular Surgery,the Second People's Hospital of Liaocheng(Liaocheng Second Hospital Affiliated to Shandong First Medical University),Liaocheng 252603,Shandong,China)

机构地区：[1]聊城市第二人民医院(山东第一医科大学附属聊城二院)心脏大血管外科,山东聊城252603

出　　处：《血管与腔内血管外科杂志》2024年第7期792-796,共5页Journal of Vascular and Endovascular Surgery

基　　金：山东省医药卫生科技发展计划项目(2017WSA15108)。

摘　　要：目的探讨多层螺旋计算机断层扫描(CT)多维重建(MPR)参数、血管活性药物评分(VIS)在急性主动脉夹层预后中的预测价值。方法收集2017年4月至2022年4月于聊城市第二人民医院(山东第一医科大学附属聊城二院)进行手术治疗的68例急性主动脉夹层患者的临床资料,根据是否发生院内死亡将其分为死亡组(n=24)和对照组(n=44)。对比两组患者的主动脉夹层的MPR参数、血管活性药物评分(VIS),绘制受试者工作特征(ROC)曲线分析MPR参数与VIS预测急性主动脉夹层患者院内死亡的价值,采用Logistic回归模型分析MPR参数、VIS与患者术后发生院内死亡风险的关系。结果死亡组患者侵犯血管条数、假腔面积占主动脉管腔面积之比、VIS均高于对照组患者,差异均有统计学意义(P﹤0.05)。中性粒细胞与淋巴细胞计数比值(NLR)越高、输血量越大、呼吸机使用时间越长、合并败血症、合并肺部感染、并发意识障碍、假腔面积占主动脉管腔面积之比升高、VIS升高均是急性主动脉夹层患者术后发生院内死亡的独立危险因素(P﹤0.05)。ROC曲线分析显示,侵犯血管条数、假腔面积占主动脉管腔面积之比、VIS预测急性主动脉夹层患者术后死亡风险的曲线下面积(AUC)分别为0.611、0.861、0.949。结论假腔面积占主动脉管腔面积之比、VIS可在一定程度上预测急性主动脉夹层患者术后发生院内死亡的风险,值得在临床上进一步推广应用。Objective To investigate the multi-slice spiral computer tomography(CT)multi-dimensional reconstruction(MPR)parameters and vasoactive inotropic score(VIS)in acute aortic dissection.Method Clinical data of 68 patients with acute aortic dissection who underwent surgical treatment in the Second People's Hospital of Liaocheng(Liaocheng Second Hospital Affiliated to Shandong First Medical University)from April 2017 to April 2022 were collected,they were divided into death group(n=24)and control group(n=44)according to whether hospital death occurred.The MPR parameters and vasoactive drug score(VIS)of aortic dissection in the two groups were compared,the receiver operator characteristic(ROC)curve was drawn to analyze the value of MPR parameters and VIS in predicting hospital death in patients with acute aortic dissection.Logistic regression model was used to analyze the relationship between MPR parameters,VIS and the risk of postoperative hospital death in patients.Result The number of invasive vessels,the ratio of false lumen area to active lumen area and VIS in death group were higher than those in control group,with statistical significance(P<0.05).The higher the level of neutrophil to lymphocyte ratio(NLR),the larger the amount of blood transfusion,the longer the time of ventilator use,the complicated sepsis,the complicated pulmonary infection,the complicated consciousness disturbance,the higher the ratio of false lumen to active lumen area,and the higher VIS were the independent risk factors for hospital death in patients with acute aortic dissection(P<0.05).ROC curve analysis showed that the number of invasive vessels,the ratio of false lumen area to active lumen area,and the area under the curve(AUC)of VIS in predicting postoperative death risk in patients with acute aortic dissection were 0.611,0.861,and 0.949,respectively.Conclusion The ratio of false lumen area to active lumen area and VIS can predict the risk of hospital death in patients with acute aortic dissection to a certain extent,and are worthy of fur

关 键 词：急性主动脉夹层 死亡 多层螺旋计算机断层扫描 多维重建 血管活性药物评分 

分 类 号：R543[医药卫生—心血管疾病]