经胸超声心动图联合外周血管超声诊断肺栓塞的价值研究  

Value of Transthoracic Echocardiography Combined with Peripheral Vascular Ultrasound in the Diagnosis of Pulmonary Embolism

作　　者：刘霖 胡春梅 王颖琦 陈梦宇 雷静 廖懿 LIU Lin;HU Chunmei;WANG Yingqi;CHEN Mengyu;LEI Jing;LIAO Yi(Department of Ultrasound Diagnosis,Xinyu People's Hospital,Xinyu 338025,Jiangxi,China)

机构地区：[1]新余市人民医院超声诊断科,江西新余338025

出　　处：《医学信息》2025年第9期149-152,共4页Journal of Medical Information

基　　金：新余市科技计划项目(编号:20233090909)。

摘　　要：目的探讨结合经胸超声心动图和外周血管超声在肺栓塞诊断中的应用效果。方法选取2022年1月-2024年1月新余市人民医院收治的45例肺栓塞患者作为研究组,另选取同时间段内的45位健康体检者作为对照组。应用彩色多普勒超声诊断仪测量两组的右心室舒张末期容积(RVEDV)、右心室收缩末期容积(RVESV)、右心室射血分数(RVEF)、三尖瓣反流速度(Vp)和肺动脉收缩压(SPAP)。利用受试者工作特征曲线(ROC)评估这些指标对肺栓塞预测的效能,并分析这些指标联合预测的一致性。结果研究组的RVESV、RVEDV、Vp和SPAP数值高于对照组,而RVEF则低于对照组(P<0.05)。ROC曲线分析显示,RVESV≥33.013 ml、RVEDV≥73.522 ml、Vp≥3.635 m/s、SPAP≥42.006 mmHg和RVEF≤36.382%是预测肺栓塞的最佳阈值(P<0.05)。一致性分析表明,RVESV、RVEDV、RVEF、Vp和SPAP指标联合预测肺栓塞具有高度一致性(Kappa=0.893)。结论结合胸超声心动图和外周血管超声测定的RVESV、RVEDV、RVEF、Vp和SPAP指标水平对肺栓塞的预测具有高敏感性和特异性,临床应用价值较高。Objective To investigate the application effect of combined transthoracic echocardiography and peripheral vascular ultrasound in the diagnosis of pulmonary embolism.Methods Forty-five patients with pulmonary embolism admitted to Xinyu People's Hospital from January 2022 to January 2024 were selected as the study group,and 45 healthy subjects in the same period were selected as the control group.The right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricular ejection fraction(RVEF),tricuspid regurgitation velocity(Vp)and systolic pulmonary artery pressure(SPAP)were measured by color Doppler ultrasonography.The receiver operating characteristic curve(ROC)was used to evaluate the efficacy of these indicators in predicting pulmonary embolism,and the consistency of the combined prediction of these indicators was analyzed.Results The RVESV,RVEDV,Vp and SPAP values of the study group were higher than those of the control group,while the RVEF was lower than that of the control group(P<0.05).ROC curve analysis showed that RVESV≥33.013 ml,RVEDV≥73.522 ml,Vp≥3.635 m/s,SPAP≥42.006 mmHg and RVEF≤36.382%were the best thresholds for predicting pulmonary embolism(P<0.05).Consistency analysis showed that RVESV,RVEDV,RVEF,Vp and SPAP were highly consistent in predicting pulmonary embolism(Kappa=0.893).Conclusion The levels of RVESV,RVEDV,RVEF,Vp and SPAP measured by transthoracic echocardiography and peripheral vascular ultrasound have high sensitivity and specificity in the prediction of pulmonary embolism,and have high clinical application value.

关 键 词：经胸超声心动图 外周血管超声 肺栓塞 

分 类 号：R563.5[医药卫生—呼吸系统]