多层螺旋CT与超声心动图对急性肺栓塞患者右心功能的评估价值

Value of multi-slice spiral CT and echocardiogram in evaluation of right heart function in patients with acute pulmonary embolism

目的探讨多层螺旋CT与超声心动图对急性肺栓塞患者右心功能的评估价值。方法回顾性选取2017年10月—2019年12月收治的90例急性肺栓塞患者纳入观察组,并选取同期接受体检的无肺栓塞者90例纳入对照组。记录并比较2组多层螺旋CT、超声心电图检查结果和心功能[血浆脑钠肽(BNP)、左心室射血分数(LVEF)、左室舒张末期内径(LVEDd)]检查结果。结果多层螺旋CT检查显示,观察组右心室与左心室最大内径比值(RVD/LVD)、右心室与左心室间最大距离比值(RV-LD/LV-LD)、右心室与左心室最大截面积比值(RVA/LVA)均高于对照组,差异有统计学意义(P <0.05);2组肺动脉主干及主动脉内径比值(PA/AO)比较,差异无统计学意义(P> 0.05)。超声心电图检查显示,观察组右心室横径与左心室横径比值(RVTD/LVTD)、三尖瓣反流压差(TRPG)、主肺动脉内径(PA)大于对照组,差异有统计学意义(P <0.05)。观察组BNP水平高于对照组,LVEDd大于对照组,LVEF低于对照组,差异有统计学意义(P <0.05)。结论多层螺旋CT与超声心动图检测均能为急性肺栓塞患者右心功能评估提供可靠的影像学依据。

Objective To explore the value of multi-slice spiral CT and echocardiogram in evaluating the right heart function in patients with acute pulmonary embolism. Methods A total of 90 patients with acute pulmonary embolism admitted from October 2017 to December 2019 were retrospectively selected as observation group,and 90 patients without pulmonary embolism who received physical examination during the same period were selected as control group. The results of multi-slice spiral CT test,echocardiogram test and cardiac function[plasma brain natriuretic peptide( BNP),left ventricular ejection fraction( LVEF),and left ventricular end-diastolic diameter( LVEDd) ]were recorded in two groups. Results The findings of multi-slice spiral CT showed that ratio of the maximum inner diameter of right ventricle to left ventricle( RVD/LVD),the ratio of the maximum distance between the left ventricle and right ventricle( RV-LD/LV-LD),and the ratio of the maximum cross-sectional area of right ventricle to left ventricle( RVA/LVA) of the observation group were significantly higher than those of the control group( P < 0. 05),but the ratio of the inner diameter of main pulmonary artery to the aorta( PA/AO) between two groups showed no significant difference( P > 0. 05).The findings of echocardiogram showed that the ratio of left to right ventricular transverse diameter( RVTD/LVTD),pressure difference of tricuspid regurgitation( TRPG),inner diameter of the main pulmonary artery( PA) of the observation group were significantly higher than those of the control group( P < 0. 05);the level of BNP of the observation group was significantly higher,and left ventricular end-diastolic diameter( LVEDd) was significantly greater,and left ventricular ejection fraction( LVEF)was significantly lower than those of the control group( P < 0. 05). Conclusion Multi-slice spiral CT and echocardiography can provide reliable imaging basis for the evaluation of right heart function in patients with acute pulmonary embolism.