慢性肺部病变过程与主肺动脉直径的关系

Relationship between main pulmonary artery diameter and process of chronic pulmonary disease

目的:探讨慢性肺部病变过程的主肺动脉直径变化。方法:选取中南大学湘雅二医院100例慢性肺疾病的患者以及9例无肺疾病的对照组患者。其中肺部病变患者分为单纯慢性肺部疾病组37例、慢性肺源性心脏病代偿期组20例、慢性肺源性心脏病失代偿期组43例。肺部CT检测患者的主肺动脉直径,分析比较4组的主肺动脉直径变化。结果:Spearman分析示肺部病变的进展与主肺动脉直径(r=0.78,P<0.001)呈强正相关。平均主肺动脉直径慢性肺源性心脏病失代偿期组>慢性肺源性心脏病代偿期组>单纯慢性肺部疾病组>无肺疾病的对照组(P<0.05)。取主肺动脉直径>29 mm时判定肺源性心脏病,灵敏度92.3%,特异度58.5%。结论:主肺动脉直径可反映慢性肺疾病患者的病情进展情况,并对肺源性心脏病的诊断有一定的提示作用。

Objective: To explore the relationship between main pulmonary artery diameter and process of chronic pulmonary disease.Methods: We retrospectively reviewed 9 cases without pulmonary diseases(control group) and 100 cases with chronic pulmonary diseases, which were divided into 3 groups: the simple chronic pulmonary disease(A group, 37 cases), the compensatory period of chronic cor pulmonale(B group, 20 cases) and the decompensatory period of chronic cor pulmonale(C group, 43 cases). Main pulmonary artery diameter(MPAD) was measured by chest CT. The differences of MPAD among these 4 groups were analyzed.Results: There was a strong positive correlation between pulmonary artery diameter and process of chronic pulmonary disease. Mean MPAD in the group C was higher than that in the group B(P<0.05), and mean MPAD in the group B was higher than that in the group A(P<0.05). Mean MPAD in control group was the smallest one among all groups(P<0.05).Conclusion: Main pulmonary artery diameter could reflect the process of chronic pulmonary disease.