中高危急性肺栓塞患者肺动脉CT血管造影量化指标与栓塞程度、心脏生物标志物的相关性  

The correlation of quantitative indicators of pulmonary artery CT angiography with the degree of embolism and cardiac biomarkers in patients with medium-to-high risk acute pulmonary embolism

作　　者：陈启鸿 高晓杰 林剑雄 张庆贤 黄金旗 CHEN Qihong;GAO Xiaojie;LIN Jianxiong;ZHANG Qingxian;HUANG Jinqi(Department of Interventional Vascular Surgery,Putian Municipal First Hospital,Putian,Fujian Province 351100,China)

机构地区：[1]莆田市第一医院介入血管外科,福建莆田351100

出　　处：《介入放射学杂志》2025年第1期74-78,共5页Journal of Interventional Radiology

摘　　要：目的探讨中高危急性肺栓塞(APE)患者肺动脉CT血管造影(CTPA)横断面测量的肺动脉直径(PAD)、PAD/主动脉直径(AOD)、右心室直径(RVD)、RVD/左心室直径(LVD)与栓塞程度、心脏生物标志物的相关性。方法纳入2021年1月至2023年12月于莆田市第一医院接受介入治疗的中高危APE患者53例。在CTPA横断面测量PAD、PAD/AOD、RVD、RVD/LVD,分析上述指标与CT栓塞指数(CTEI)、氨基末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)的相关性。结果PAD、RVD、RVD/LVD与CTEI存在弱-中等度正相关(r分别为0.506、0.310、0.452,P值分别为<0.001、0.024、0.001),PAD/AOD与CTEI不存在相关性(r=0.247,P=0.075)。与NT-proBNP阴性组比较,阳性组PAD、PAD/AOD、RVD/LVD较高(均P<0.05),2组间RVD差异无统计学意义(P>0.05)。NT-proBNP与PAD、PAD/AOD、RVD、RVD/LVD存在弱-中等度正相关(r分别为0.454、0.326、0.302、0.405,P值分别为0.001、0.017、0.028、0.003)。cTnI阴性组和阳性组间PAD、PAD/AOD、RVD、RVD/LVD差异均无统计学意义(均P>0.05)。cTnI与PAD、PAD/AOD、RVD、RVD/LVD均不存在相关性(r分别为0.188、0.042、-0.021、0.139,P值分别为0.195、0.772、0.884、0.342)。结论CTPA横断面量化指标有助于评估APE栓塞程度和右心功能,但不能用于评估心肌损伤。Objective To explore the correlation between the pulmonary artery diameter(PAD),PAD/aortic diameter(AOD),right ventricular diameter(RVD),RVD/left ventricular diameter(LVD) measured on pulmonary artery CT angiography(CTPA) cross-sectional images and the degree of embolism, cardiac biomarkers in patients with medium-to-high risk acute pulmonary embolism(APE).Methods The clinical data of 53 patients with medium-to-high risk APE,who received interventional treatment at the Putian Municipal First Hospital of China From January 2021 to December 2023,were retrospectively analyzed.The PAD,PAD/AOD,RVD,and RVD/LVD were measured on CTPA cross-sectional images.The correlations of the above indexes with CT embolism index(CTEI),N terminal pro B type natriuretic peptide(NT-proBNP),and cardiac troponin I(cTnI) were analyzed.Results A weak-moderate positive correlation existed between PAD,RVD,RVD/LVD and CTEI(r=0.506,r=0.310,r=0.452 respectively, P<0.001,P=0.024,P=0.001 respectively),while no correlation existed between PAD/AOD and CTEI(r=0.247,P=0.075).Compared with the NT-proBNP negative group, in the NT-proBNP positive group the values of PAD,PAD/AOD and RVD/LVD were higher(all P<0.05),and there was no statistically significant difference in RVD value between the two groups(P>0.05).A weak-moderate positive correlation existed between NT-proBNP and PAD,PAD/AOD,RVD,RVD/LVD(r=0.454,r=0.326,r=0.302,r=0.405 respectively, P=0.001,P=0.017,P=0.028,P=0.003 respectively).There were no statistically significant differences in PAD,PAD/AOD,RVD and RVD/LVD values between the cTnI negative group and the cTnI positive group(all P>0.05).No correlation existed between cTnI and PAD,PAD/AOD,RVD,RVD/LVD(r=0.188,r=0.042,r=-0.021,r=0.139 respectively, and P=0.195,P=0.772,P=0.884,P=0.342 respectively).Conclusion CTPA cross-sectional quantitative indicators are helpful in evaluating the embolism degree of APE and right heart function, but it cannot be used to assess myocardial injury.

关 键 词：急性肺栓塞 肺动脉CT血管造影 量化指标 心脏生物标志物 相关性 

分 类 号：R655.3[医药卫生—外科学]