CT肺动脉造影定量参数评估中心肺栓塞患者右心功能及预后

目的探讨CT肺动脉造影定量参数评估中心肺栓塞患者右心功能及预后的价值。方法回顾性分析200例中心肺栓塞患者,住院期间死亡35例(死亡组)、存活165例(存活组);对比2组患者CT肺动脉造影定量参数及右心功能。结果与存活组比较,死亡组患者CT肺动脉阻塞指数及右心室短轴最大径(RVSAMD)、RVSAMD/左心室短轴最大径(LVSAMD)、肺动脉直径均增加(P均0.001),2组LVSAMD差异无统计学意义(P=0.131)。多因素Logistic回归分析显示,CT肺动脉阻塞指数、RVSAMD、RVSAMD/LVSAMD和肺动脉直径增加是中心肺栓塞患者死亡的危险因素(P均0.05)。Pearson线性回归分析显示,CT肺动脉阻塞指数、RVSAMD/LVSAMD、肺动脉直径与RVSAMD均呈正相关(P均0.05)。结论 CT肺动脉造影定量参数对预测中心肺栓塞患者右心功能和预后具有一定价值。

Quantitative parameters of CT pulmonary angiography for evaluation on right heart function and prognosis of patients with central pulmonary embolism

Objective To explore the value of quantitative parameters of CT pulmonary angiography in evaluating right heart function and prognosis of patients with central pulmonary embolism. Methods Clinical data of 200 patients with central pulmonary embolism were retrospectively analyzed, including 35 cases died (death group) and 165 cases survived (survival group) during hospitalization. The quantitative parameters of CT pulmonary angiography and right heart function were compared between 2 groups. Results Compared with the survival group, the pulmonary artery occlusion index, right ventricular short axis maximum diameter (RVSAMD), RVSAMD/left ventricular short axis maximum diameter (LVSAMD), pulmonary artery diameter in the death group all increased (all P<0.001). There was no significant difference of LVSAMD between 2 groups (P=0.131). Multivariate Logistic regression analysis showed that CT pulmonary artery occlusion index, RVSAMD, RVSAMD/LVSAMD and increase of pulmonary artery diameter were the risk factors of death in patients with central pulmonary embolism (all P<0.05). Pearson linear regression analysis showed that CT pulmonary artery occlusion index, RVSAMD/LVSAMD and pulmonary artery diameter were all positively correlated with RVSAMD (all P<0.05). Conclusion The quantitative parameters of CT pulmonary angiography have certain value in predicting right heart function and prognosis of patients with central pulmonary embolism.