CT肺动脉阻塞指数与血气分析值评价急性肺栓塞严重性的研究

Study on the severity of acute pulmonary embolism evaluated by CT obstruction index and arterial blood gas analysis

目的研究CT阻塞指数与血气分析评价急性肺栓塞(APE)严重性的价值。方法接受CTPA和动脉血气分析检查并且无基础心肺疾病的APE患者共59例。利用肺动脉CT阻塞指数评价肺动脉栓子阻塞程度与范围。动脉血气分析包括PaCO2、PaO2、SaO2及P(A-a)O2。严重APE组和非严重APE组患者之间的CT阻塞指数、动脉血气分析指标之间的统计学差异用t检验评价。阻塞指数与动脉血气分析指标之间的相关性使用Spearman相关系数评价。结果严重APE组患者的PaCO2、PaO2及SaO2明显低于非严重APE组患者(P<0.01),而P(A-a)O2明显高于非严重APE患者(P<0.01)。阻塞指数分别与PaCO2、PaO2、SaO2及P(A-a)O2的相关性有统计学意义(P<0.01)。结论综合分析APE患者的肺动脉阻塞指数、血气分析指标有利于评价APE患者的严重性。

Objective To study the value of CT obstruction index and arterial blood gas analysis on evaluating the severi- ty of the patients with APE. Methods Fifty-nine patients with APE but no underlying cardiopulmonary disease had un- dergone CTPA examination and artery blood gas analysis. Pulmonary artery clot load was assessed by the pulmonary arter- y obstruction index. Atery blood gases included PaCO2 , PaO2, SaO2, and P（A-a）O2. T test was used to evaluate the sta- tistical difference of CT obstruction index and the arterial blood gas values between severe and non severe pulmonary em- bolism. Spearman＇s rank correlation coefficients were used to assess the correlation between arterial obstruction index and blood gas values. Results The values of PaCO2, PaO2, and SaO2 were significantly lower and P（A-a）O2 were significant- ly higher in the severe group than non severe group （ P d0.01）. Correlations between the obstruction index and PaCO2, PaO2, SaO2 , and P（A-a）O2 were statistically different （ P d0.01）. Conclusion CT obstruction index and arterial blood gas analysis are helpful for evaluating the severity of the patients with APE.