肺动脉高压患者随访及CT定量监测的评估价值研究  

A study of the relationship between CT parameters of pulmonary small vessel parameters and the prognosis of patients with pulmonary hypertension

作　　者：蔡磊磊 Cai Leilei(Department of Radiology,Baofeng Branch,the Second People′s Hospital of Pingdingshan City,Pingdingshan 467400,China)

机构地区：[1]平顶山市第二人民医院宝丰分院放射科,平顶山467400

出　　处：《实用医技杂志》2025年第1期42-46,共5页Journal of Practical Medical Techniques

摘　　要：目的研究CT肺小血管参数与肺动脉高压患者预后的关系。方法回顾分析2022年7至2024年7月在我院接受治疗的68例肺动脉高压患者的CT扫描资料,按照治疗5 d后的预后结局分为预后良好组(39例)和预后不良组(29例),对比2组患者入院治疗2周后CT肺小血管参数,应用logistic回归分析模型进行多因素分析,并多元回归分析CT肺小血管参数与肺动脉高压患者预后的相关性,以及应用受试者工作特征曲线(ROC曲线)分析CT肺小血管参数预测肺动脉高压患者预后的临床价值。结果预后不良组的血管横截面积(CSA)和5~10 mm^(2)血管总横截面积/肺野总面积(CSA5-10)低于预后良好组[CSA:(5.6±1.5)mm^(2)和(7.1±1.6)mm^(2),t=3.830,P<0.001;%CSA5-10:(41.8±7.3)%和(761.3±11.2)%,t=8.663,P<0.001],预后不良组<5 mm^(2)血管总横截面积/肺野总面积(%CSA<5)高于预后良好组[CSA:(59.5±5.8)%和(47.2±9.9)%,t=-6.451,P<0.001]。多元回归分析法分析发现CSA[OR值(95%CI)=0.457(0.307,0.680),P<0.001]、%CSA5-10[OR值(95%CI)=0.498(0.253,0.980),P<0.001]和%CSA<5[OR(95%CI)=2.375(1.377,4.095),P<0.001]等CT肺小血管参数与肺动脉高压患者的预后具有相关性。ROC曲线分析发现,%CSA5-10预测肺动脉高压患者预后的临床价值良好[AUC(95%CI)=0.924(0.833,0.974),P<0.001]。结论CT肺小血管参数与肺动脉高压患者预后具有一定的相关性,且可为临床预测患者预后提供有效客观依据。Objective To investigate the relationship between CT parameters of pulmonary small vessels and prognosis of patients with pulmonary hypertension.Methods CT scan data of 68 patients with pulmonary hypertension treated in our hospital from January 2020 to December 2022 were retrospectively analyzed.All patients were followed up for one year,and were divided into good prognosis group(n=39 cases)and poor prognosis group(n=29)according to follow-up outcomes.CT parameters of pulmonary small vessels were compared two weeks after admission.Multivariate regression was used to analyze the correlation between CT pulmonary small vessel parameters and the prognosis of patients with pulmonary hypertension,and receiver operating characteristic curve(ROC curve)was used to analyze the clinical value of CT pulmonary small vessel parameters in predicting the prognosis of patients with pulmonary hypertension.Results The CSA and%CSA5-10 in the poor prognosis group were lower than those in the good prognosis group[CSA:(5.6±1.5)mm^(2) vs.(7.1±1.6)mm^(2);t=3.830,P<0.001;%CSA5-10:(41.8±7.3)%vs.(61.3±11.2)%;t=8.663,P<0.001],the%CSA<5 in the poor prognosis group was higher than that in the good prognosis group[CSA:(59.5±5.8)%vs.(47.2±9.9)%;t=-6.451,P<0.001].Multiple regression analysis found that CSA[OR(95%CI)=0.457(0.307,0.680),P<0.001],%CSA5-10[OR(95%CI)=0.498(0.253,0.980),P<0.001]and%CSA<5[OR(95%CI)=2.375(1.377,4.095),P<0.001]were correlated with the prognosis of patients with pulmonary hypertension.ROC curve analysis showed that%CSA5-10 had good clinical value in predicting the prognosis of patients with pulmonary hypertension[AUC(95%CI)=0.924(0.833,0.974),P<0.001].Conclusion CT parameters of pulmonary small vessels have a certain correlation with the prognosis of patients with pulmonary hypertension,and can provide an effective objective basis for clinical prediction of patient prognosis.

关 键 词：肺动脉高压 CT 肺小血管 预后 相关性 预测价值 

分 类 号：R54[医药卫生—心血管疾病]