下肢静脉病变与肺动脉栓塞关系的研究

目的 探讨下肢静脉病变与肺栓塞（PE）发病之间的关系。方法 对50例正常对照者和200例临床高度怀疑PE和下肢静脉病变的患者，行^99Tc^m-大颗粒聚合白蛋白（MAA）和^99Tc^m-葡聚糖酯（GP）双下肢静脉显像和肺灌注/通气显像，其中15例进行了肺动脉造影。结果 对照组下肢静脉显像和肺灌注/通气显像均显示正常，200例患者肺灌注/通气显像示：175例为多发性PE，25例正常。175例PE患者中128例有下肢静脉病变，占73.14%（128/175例），其中下肢深静脉血栓（DVT）119例，占68.00%（119/175例）；25例非PE者均有下肢静脉病变。153例下肢静脉病变者中检出PE128例，占83.66%(128/153例）。下肢DVT 119例，其中由髂、股静脉血栓引发PE者101例，占84.87%（101/119例）。结论 双下肢静脉显像与肺灌注/通气显像联合应用，有助于PE及其病因的诊断。

A study on the relationship between deep vein thrombosis of lower extremities and pulmonary embolism

Objective To evaluate the relationship between deep vein thrombosis (DVT) and pulmonary embolism (PE) and the origin of PE. Methods Fifty normal people and 200 patients with highly suspected PE and DVT of lower extremities underwent pulmonary perfusion/ventilation (P/V) imaging with 99 Tc m macroaggregated albumin (MAA) and 99 Tc m glucose phosphate (GP), 15 patients among them also underwent pulmonary artery angiography. Results Fifty normal people gave normal images of P/V. Among 200 patients, 175 were with multiple PE, 25 were normal; among PE patients, 128 were with lower extremity venous disorders (73.14%), 25 cases without PE were all with extremity venous disorders; among 153 with lower extremity venous diseases, 128 were with PE (83.66%); 119 of them had DVT, 101 cases' PEs originated from iliofemoral vein thrombosis (84.87%). Conclusion It is effective to diagnosis PE and its origin with combinative use of pulmonary perfusion/ventilation imaging and lower extremity vein imaging.