胸部CT参数对结缔组织病相关肺动脉高压的分级诊断及预后评估  

Graded Diagnosis and Prognostic Evaluation of Pulmonary Arterial Hyperten⁃sion Related to Connective Tissue Disease Using Chest CT Parameters

作　　者：柏钦文 岳欢欢 潘虹池 BAI Qinwen;YUE Huanhuan;PAN Hongchi(Department of Respiratory and Critical Care Medicine,Dazhou Central Hospital,Sichuan 635000,China)

机构地区：[1]达州市中心医院呼吸与危重症医学科,四川635000

出　　处：《影像科学与光化学》2025年第2期95-102,共8页Imaging Science and Photochemistry

摘　　要：目的:探讨胸部CT参数在结缔组织病相关肺动脉高压(CTD⁃PAH)分级诊断及预后评估中的应用价值。方法:回顾性分析2017年12月至2020年12月我院收治的178例CTD⁃PAH患者临床资料和胸部CT图像,将患者根据肺细小动脉病理改变分为Ⅰ~Ⅳ级,并根据随访结果分为死亡组和存活组。通过多元线性回归分析和广义混合效应模型,探讨胸部CT参数与肺循环血流动力学参数的相关性及预后影响因素。结果:Ⅳ级及以上患者的主肺动脉直径(MPAD)、主肺动脉与升主动脉直径比值(rPA)、主肺动脉与降主动脉直径比值(rPD)与肺循环血流动力学参数呈正相关(P<0.05)。预后分析显示,MPAD、rPA和rPD是CTD⁃PAH患者预后的独立影响因素(P<0.05),且与预后呈线性剂量⁃反应关系(Pnon⁃linearity>0.05)。结论:胸部CT参数与CTD⁃PAH的分级密切相关,可作为预后评估的重要指标。Objective:To explore the application value of chest CT parameters in the grading diagnosis and prognosis evaluation of connective tissue disease⁃related pulmonary arterial hypertension(CTD⁃PAH).Methods:A retrospective analysis was conducted on the clinical data and chest CT images of 178 CTD⁃PAH patients admitted to our hospital from December 2017 to December 2020.Patients were classified into gradesⅠtoⅣbased on pathological changes in pulmonary arterioles,and were divided into death group and survival group according to follow⁃up results.Exploring the correlation and prognostic factors between chest CT parameters and pulmonary hemodynamic parameters through multiple linear stepwise regression analysis and generalized mixed effects model.Results:Patients with gradeⅣor above showed a positive correlation between the main pulmonary artery diameter(MPAD),the ratio of main pulmonary artery to ascending aorta diameter(rPA),the ratio of main pulmonary artery to descending aorta diameter(rPD),and pulmonary circulatory hemodynamic parameters(P<0.05).Prognostic analysis showed that MPAD,rPA,and rPD were independent influencing factors for the prognosis of CTD⁃PAH patients(P<0.05),and had a linear dose⁃response relationship with prognosis(Pnon⁃linearity>0.05).Conclusion:The chest CT parameters are closely related to the grading of CTD⁃PAH and can serve as important prognostic indicators.

关 键 词：胸部CT参数 结缔组织病 肺动脉高压 分级诊断 预后评估 

分 类 号：R563[医药卫生—呼吸系统]