高原肺水肿X线影像学分型与临床表现的相关性研究

Study on the Correlation Between X-ray Image Classification and Clinical Features of High Altitude Pulmonary Edema

目的 探讨高原肺水肿(high altitude pulmonary edema, HAPE)患者胸部X线表现与临床的内在联系。方法 收集2021-03~10月作者医院收治的85例HAPE患者资料,以胸片分型为介导,进一步统计分析各型HAPE与血氧饱和度(blood oxygen saturation, SpO_(2))和住院时间的相关性。结果 间质型HAPE 21例,肺部渗出程度定为1级,SpO_(2)平均(73.2±5.2)%,住院日平均(3.3±1.0)天;局限型HAPE 36例,肺部渗出程度定为2级,SpO_(2)平均(71.3±6.1)%,住院日平均(4.0±1.5)天;中心型HAPE 13例,肺部渗出程度定为3级,SpO_(2)平均(65.1±11.2)%,住院日平均(5.3±1.5)天;弥漫型HAPE 15例,肺部渗出程度定为3级,SpO_(2)平均(55.1±12.1)%,住院日平均(4.4±1.0)天。HAPE肺部渗出程度分级与SpO_(2)呈负相关(r=-0.52,P<0.01),与住院日呈正相关(r=0.41,P<0.01),SpO_(2)与住院日呈负相关(r=-0.22,P<0.05)。结论 HAPE患者X线上肺部渗出程度越重,SpO_(2)越低,住院时间越长。肺部渗出面积与SpO_(2)能够反映HAPE病情严重程度,还是疗效评价的有效指标。

Objective To explore the internal relationship between chest X-ray and clinic of high altitude pulmonary edema(HAPE).Methods The correlation between severity grading of pulmonary exudation mediated by chest radiograph classification of HAPE, blood oxygen saturation(SpO_(2)) and hospitalization time of 85 HAPE patients in a mission unit in high altitude from March to October 2021 was analyzed.Results There were 21 cases of interstitial type HAPE, the degree of pulmonary exudation was rated as grade 1, the average SpO_(2)was(73.2±5.2)%, and the average hospitalization day was(3.3±1.0)days;there were 36 cases of localized type HAPE, the degree of pulmonary exudation was rated as grade 2, the average SpO_(2)was(71.3±6.1)%, and the average hospitalization day was(4.0±1.5)days;there were 13 cases of central type and 15 cases of diffuse type HAPE, the degree of pulmonary exudation both were rated as grade 3, the average SpO_(2)were(65.1±11.2)% and(55.1±12.1)% respectively, and the average hospitalization day were(5.3±1.5)and(4.4±1.0) days. The grade of pulmonary exudation of HAPE was negatively correlated with blood oxygen saturation(r=-0.52, P<0.01), positively correlated with hospitalization day(r=0.41, P<0.01), SpO_(2)was negatively correlated with hospitalization day(r=-0.22, P<0.05).Conclusion The more severe the pulmonary exudation on the chest X-ray, the lower SpO_(2)and the longer hospitalization day of HAPE patients. The degree of pulmonary exudation and SpO_(2)can reflect the severity of HAPE, which are also effective indicators for efficacy evaluation.