慢性肺源性心脏病的早期X线诊断(附120例分析)

X-Ray Diagnosis of Early Chronic Cor Pulmonale(Report 120 Cases)

目的 :探讨胸片对慢性肺源性心脏病的早期诊断价值。材料与方法 :将 12 0例分成四组 ,分别为 :肺心病组、早期组、可疑组和慢支组 ,按照 1997年制订的肺心病诊断标准分析它们的正位胸片资料。结果 :肺心病组中 4 6例 (92 % )有肺动脉高压征 ,5 0例 (10 0 % )有残根征 ,4 2例 (84 % )有右心室增大征 ;早期组中 2 1例 (70 % )有肺动脉高压征 ,2 1(70 % )有残根征 ,2 4例 (80 % )有右心室增大征 ;可疑组中 8例 (5 3% )有肺动脉高压征 ,9例 (6 0 % )有残根征 ,1例 (6 6 % )有右心室增大征 ;慢支组中无肺动脉高压征、残根征和右心室增大征。结论 :胸片诊断慢性肺源性心脏病的敏感性较高 ,可结合临床对慢性肺源性心脏病作出早期诊断 ,肺动脉高压为其重要征象。

Purpose:To discuss the value of plain chest film in diagnosing early Chronic Cor Pulmonale.Materials and Methods:120 cases with COPD were classified into 4 groups:Chronic Cor Pulmonale,early Chronic Cor Pulmonale,doubtful Chronic Cor Pulmonale and Chronic Bronchitis.Their PA chest films were analyzed based on the diagnostic criterion of Chronic Cor Pulmonale which was formulated in 1977.Results:Within the Chronic Cor Pulmonale group,46 cases show pulmonary artery hypertension,50 cases show 'residual root' sign of right lower pulmonary artery and 42 cases show enlargement of right ventricle;Within the doubtful Chronic Cor Pulmonale group only 8 cases show pulmonary artery hypertension,9 cases show 'residual root' sign and 1 cases show enlargement of right ventricle;Within the Chronic Bronchitis group,no cases show pulmonary artery hypertension,'residual root' sign or enlargement of right ventricle.Conclusion:Plain chest film is sensitive and of high value in diagnosing early Chronic Cor Pulmonale.The valuable sign is hypertension of the pulmonary artery.