肺灌注显像在肺心病患者肺动脉压测定中的应用

目的探讨肺灌注显像判定肺心病患者肺动脉高压的程度及其意义。方法对28例肺心病患者及10例正常受试者行99mTc—MAA单光子发射计算机断层测定，测量肺灌注显像上、下肺野核素计数比值，同时应用超声检测收缩期三尖瓣返流压力阶差（the tricuspid valve regurgitation pressure gradient biggest，TRPG）估测肺动脉压（pulmonary artery pressure，PAP）作对照。结果肺动脉压力轻度升高时，肺上、下肺野核素计数比值高于正常对照组，组间存在有显著差异（P〈0．01），且肺上、下肺野核素计数比值与超声检测肺动脉压值呈正相关（r=0．82．t=7．31，P〈0．01）。结论肺灌注显像属先进的无创性技术，可应用来判定肺动脉高压的程度，联合心脏超声检测在肺心病的诊治上有重要意义。

The Study of Pulmonary Artery Pressure by Lung Perfusion Imaging in Patients with Cor Pulmonale

Objective To study pulmonary perfusion imaging in determining of pulmonary artery hypertension in patients with cor pulmonale.Methods 28 patients with cor pulmonale were investigated with()~(99m)Tc-MAA single photon emission computed tomography.The tricuspid valve regurgitation pressure gradient biggest(TRPG) in calculating pulmonary artery pressure was used in control group.Results The ratio of upper/lower radiopharmaceuticals distribution measured with pulmonary perfusion tomographic imaging was significantly higher in pulmonary artery hypertension than that of the control(P<0.01). The ratio and the pulmonary artery pressure according to TRPG were positively related(P<0.01).Conclusion Lung perfusion imaging is an advanced noninvasive detective method.It can estimate pulmonary artery pressure efficiently and directly.The method deserves to be further investigated.Simultaneous detections of the ratio and TRPG are valuable and play an important role in the diagnosis and treatment of patients with cor pulmonale.