能谱CT肺动脉栓塞指数和肺灌注缺损指数与急性肺栓塞患者预后的相关性分析

目的:分析能谱CT肺动脉栓塞指数(PAOI)和肺灌注缺损指数(PPDI)与急性肺栓塞患者预后的相关性。方法:回顾性分析2019年10月至2020年10月在该院接受治疗的96例急性肺栓塞患者的临床资料。患者均行能谱CT扫描,根据危险分层将其分为高危组(n=34)、中危组(n=32)和低危组(n=30),比较三组PAOI和PPDI,采用Spearman法分析能谱CT的PAOI、PPDI与急性肺栓塞患者危险分层的相关性;再根据预后情况将其分为存活组(n=67)和死亡组(n=29),比较两组PAOI和PPDI,采用ROC曲线评估PAOI、PPDI预测急性肺栓塞患者死亡风险的效能。结果:高危组PAOI和PPDI均明显高于中危组、低危组,且中危组高于低危组,差异有统计学意义(P<0.05);能谱CT的PAOI、PPDI与急性肺栓塞患者危险分层呈正相关(P<0.05);死亡组PAOI和PPDI均明显高于存活组,差异有统计学意义(P<0.05);能谱CT的PAOI、PPDI ROC曲线AUC明显大于参考线(Z_PAOI=12.864,Z_PPDI=5.802,P<0.05),其截断值分别为52.12%、59.95%。结论:能谱CT的PAOI和PPDI与急性肺栓塞患者危险分层呈正相关,PAOI和PPDI能反映急性肺栓塞患者肺栓塞和肺灌注缺损范围,预测患者死亡风险。

Correlations among pulmonary artery obstruction index and pulmonary perfusion defect index under energy spectrum CT and risk stratification of patients with acute pulmonary embolism and their efficacies in prediction of death risk

Objective:To explore correlations among pulmonary artery obstruction index(PAOI)and pulmonary perfusion defect index(PPDI)under energy spectrum CT and risk stratification of patients with acute pulmonary embolism and their efficacies in prediction of death risk.Methods:The clinical data of 96 patients with acute pulmonary embolism who were treated in this hospital from October 2019 to October 2020 were retrospectively analyzed.All patients underwent energy spectrum CT scan.According to the risk stratifications,they were divided into highrisk group(n=34),intermediate-risk group(n=32)and low-risk group(n=30).Then,the levels of PAOI and PPDI were compared among the three groups;and Spearman analysis was used to analyze the correlations among PAOI,PPDI and the risk stratification of these patients.Further,according to the prognosis,they were divided into survival group(n=67)and death group(n=29).Then,the levels of PAOI and PPDI were compared between the two groups;and the ROC curve was used to evaluate the efficacies of PAOI and PPDI in the prediction of death risk of these patients.Results:The PAOI and PPDI levels of the high-risk group were significantly higher than those of the intermediate-risk group and the low-risk group;the PAOI and PPDI levels of the intermediate-risk group were higher than those of the low-risk group;and the differences were statistically significant(P<0.05).The PAOI and PPDI under energy spectrum CT were positively correlated with the risk stratification of the patients with acute pulmonary embolism(P<0.05).The PAOI and PPDI levels of the death group were significantly higher than those of the survival group,and the differences were statistically significant(P<0.05).The AUCs of PAOI and PPDI ROC curves under energy spectrum CT were significantly larger than the reference line(Z_PAOI=12.864,Z_PPDI=5.802,P<0.05),and the cut-off values were 52.12%and 59.95%,respectively.Conclusions:The PAOI and PPDI under energy spectrum CT are positively correlated with the risk stratification of the patients with acute pulmonary embolism.The PAOI and PPDI can reflect the extent of pulmonary embolism and the pulmonary perfusion defects in these patients,and can predict the death risk.