结缔组织病相关间质性肺炎发生肺动脉高压的胸部CT影像学特征  

Chest CT imaging features of connective tissue disease-associated interstitial pneumonia complicated with pulmonary hypertension

作　　者：刘宏圃 张喜庆 高乾亮 曲月 赵蕊 王成健 林喆鹏 张燕飞 LIU Hong-pu;ZHANG Xi-qing;GAO Qian-liang;QU Yue;ZHAO Rui;WANG Cheng-jian;LIN Zhe-peng;ZHANG Yan-fei(Department of Imaging,Hebei Petro China Central Hospital,Langfang 065000,Hebei,China)

机构地区：[1]河北中石油中心医院影像科,河北廊坊065000

出　　处：《生物医学工程与临床》2025年第2期178-183,共6页Biomedical Engineering and Clinical Medicine

基　　金：廊坊市科学技术研究与发展计划项目(2023013235)。

摘　　要：目的探究结缔组织病相关间质性肺炎患者发生肺动脉高压的情况,并对其胸部CT影像学资料进行分析。方法选择2022年5月至12月在河北中石油中心医院接受治疗的126例结缔组织病相关间质性肺炎患者,其中男性25例,女性101例;年龄19~66岁,平均年龄45.32岁(标准差16.89岁);体质量指数(BMI)19.33~26.15 kg/m^(2),平均BMI 22.31 kg/m2(标准差3.11 kg/m^(2));结缔组织病类型:系统性红斑狼疮80例,混合性结缔组织病20例,其他26例。对其肺动脉高压的发生情况及临床特征进行记录,并根据患者是否发生肺动脉高压情况进行分组,即肺动脉高压组、非肺动脉高压组。对组间胸部CT影像学资料进行对比分析,并探究其诊断价值。结果126例结缔组织病患者中,42例(33.33%)发生肺动脉高压,84例未发生肺动脉高压。42例肺动脉高压组,90.48%患者出现咳痰,78.57%患者出现胸闷,气喘和咳嗽发生率分别66.67%和59.52%。两组主动脉直径[(29.98±4.11)mm vs(30.22±2.44)mm]比较,差异无统计学意义(P>0.05)。肺动脉高压组肺动脉收缩压、肺动脉直径、肺动脉/主动脉比值高于非肺动脉高压组[(60.78±23.12)mmHg vs(24.88±5.12)mmHg、(35.48±2.34)mm vs(27.45±4.13)mm、1.14±0.23 vs 0.94±0.14。P<0.05]。肺动脉收缩压、肺动脉直径、肺动脉/主动脉比值对诊断结缔组织病相关间质性肺炎患者并发肺动脉高压具有较高的诊断价值,其曲线下面积(AUC)值分别为0.914、0.920、0.846。结论结缔组织病相关间质性肺炎患者中,约三分之一发生肺动脉高压,胸闷、咳嗽、气喘和咳痰是这些患者中最常见的症状,并发肺动脉高压的患者肺动脉收缩压、肺动脉直径和肺动脉/主动脉比值显著高于未发生肺动脉高压者,且具有较高的诊断价值。Objective To investigate the incidence of pulmonary hypertension in patients with connective tissue disease-associated interstitial pneumonia,and analyze their chest CT imaging data.Methods From May to December 2022,a total of 126 patients with connective tissue disease-associated interstitial pneumonia were enrolled,which included 25 males and 101 females,aged 19-66 years old with mean age of 45.32 years old(standard deviation 16.89 years old);body mass index(BMI)was 19.33-26.15 kg/m^(2) with mean BMI of 22.31 kg/m^(2)(standard deviation 3.11 kg/m2);80 cases of systemic lupus erythematosus,20 of mixed connective tissue disease and 26 of other connective tissue disease.The occurrence and clinical characteristics of pulmonary hypertension were recorded,and according to the occurrence of pulmonary hypertension,all patients were divided into pulmonary hypertension group and non-pulmonary hypertension group.The chest CT imaging data between 2 groups were compared and analyzed,and the diagnostic value of imaging data was explored.Results Among the 126 patients with connective tissue disease,there were 42 cases(33.33%)in pulmonary hypertension group and 84 cases in non-pulmonary hypertension group.In pulmonary hypertension group,there were 90.48% patients with expectoration,78.57% with chest tightness,and the incidence of asthma and cough was 66.67% and 59.52%,respectively.There was no significant difference in aortic diameter between 2 groups[(29.98±4.11)mm vs(30.22±2.44)mm](P>0.05).The pulmonary artery systolic pressure,pulmonary artery diameter,pulmonary artery/aorta ratio in pulmonary hypertension group were significantly higher than those in non-pulmonary hypertension group[(60.78±23.12)mmHg vs(24.88±5.12)mmHg,(35.48±2.34)mm vs(27.45±4.13)mm,1.14±0.23 vs 0.94±0.14.P<0.05].The pulmonary artery systolic pressure,pulmonary artery diameter and pulmonary artery/aorta ratio showed high diagnostic value in diagnosis of connective tissue disease-related interstitial pneumonia complicated with pulmonary hypertensio

关 键 词：结缔组织病 间质性肺炎 肺动脉高压 胸部CT 临床特征 

分 类 号：R593.2[医药卫生—内科学] R563.13[医药卫生—临床医学] R544.1