低剂量CT肺动脉造影在慢阻肺继发肺动脉高压严重程度中的评估价值

The value of low-dose CT pulmonary angiography in evaluating the severity of COPD with pulmonary hypertension

目的:探讨低剂量CT肺动脉造影在慢阻肺合并肺动脉高压严重程度中的诊断价值及准确度。方法:回顾性分析2017年1月至2019年11月我院收治的50例慢性阻塞性肺疾病患者,依据超声心动图所测肺动脉平均压力将所有患者分为:轻度肺动脉高压组(35mmHg<肺动脉收缩压<50mmHg);中重度肺动脉组(50mmHg≥肺动脉收缩压)。所有研究对象均同时接受低剂量CT肺动脉造影和超声心动图检查,测量CT肺动脉造影的心血管管径,包括主肺动脉、右肺动脉、左肺动脉、升主动脉及降主动脉直径,并测算主肺动脉与升主动脉二者直径的比值(rPA)、升主动脉与降主动脉二者的直径比值(rAD)比较各组之间差异。结果:中重度组患者RPAD、LPAD及MPAD明显长于轻度组。低剂量CT肺动脉造影评估慢阻肺继发肺动脉高压的准确度约为96.34%;轻度组、中重度组的准确度大致约为93.75%、98.92%。结论:低剂量CT肺动脉造影在评估慢阻肺继发肺动脉高压严重程度中准确率较高,对于临床判断预后及治疗方案的选择有较高的临床价值。

Objective To investigate the diagnostic value and accuracy of low-dose CT pulmonary angiography in the severity of COPD combined with pulmonary hypertension.Methods A retrospective analysis in January 2017 to November 2019,our hospital of 50 patients with COPD,on the basis of echocardiography measured pulmonary artery mean pressure all of the patients can be divided into:mild pulmonary hypertension cases pulmonary artery pressure(35mmHg≤pulmonary artery systolic pressure﹤50mmHg);the relation between the pulmonary artery group(pulmonary artery systolic pressure≥50mmHg).All subjects at the same time to accept low dose CT pulmonary angiography and echocardiography,cardiovascular diameter measurement of CT pulmonary angiography,including the main pulmonary artery and right pulmonary artery,left pulmonary artery,ascending aorta and descending aorta diameter,calculating the main pulmonary artery diameter and diameter ratio of the ascending aorta(rPA),the ascending aorta and descending aorta diameter ratio(rAD)compare the differences between groups.Results RPAD,LPAD and MPAD were significantly longer in the moderate and severe group than in the mild group.The accuracy of low-dose CT pulmonary angiography in evaluating COPD with pulmonary hypertension was 96.34%.Among them,the accuracy of the mild group and the moderate and severe group was 93.75%and 98.92%.Conclusion Low-dose CT pulmonary angiography has a significant effect in evaluating the severity of COPD combines with pulmonary hypertension,with a high accuracy rate,which is conducive to the clinical judgment of prognosis and the selection of treatment plan.