急性肺栓塞后肺梗死的多因素分析及CTA表现

目的:探讨急性肺栓塞后肺梗死发生的相关因素及CT血管成像(CTA)对其诊断、鉴别诊断及预后判断的价值。方法:回顾性分析我院40例经临床确诊且均行64排CTA检查的急性肺动脉栓塞合并肺动脉高压患者。分为梗死组(9例)及非梗死组(31例)。对2组肺动脉受累范围、部位、临床检验资料等进行对比分析。结果:梗死组中央动脉受累比率、合并下肢静脉血栓疾患、持续性房颤发生率、栓塞指数均高于非梗死组(P<0.05)。而慢性阻塞性肺病发生率、肺心病等则无统计学意义。结论:中央动脉受累比率、合并下肢静脉血栓疾患、持续性房颤、高栓塞指数是急性肺栓塞后肺梗死发生重要的影响因素。而慢性阻塞性肺病、肺心病发生与否等与肺梗死发生无明显相关;CTA在肺梗死诊断及与出血性肺不张、肺萎陷等的鉴别诊断中有重要价值.

Multiple Factor Analysis and CTA Imaging of Acute Pulmonary Embolism After Pulmonary Infarction

Objective: To study the related factors of pulmonary infarction after acute pulmonary embolism and to evaluate CT angiography(CTA) on its diagnosis,differential diagnosis,and prognosis.Methods: Forty cases which were clinically diagnosed as acute pulmonary embolism complicated with pulmonary hypertension and underwent 64-slice CTA examination were retrospectively analyzed.They were divided into infarction group(n = 9) and non-infarction group(n = 31).The involvement scope and position of pulmonary artery and clinical data were compared and analyzed.Results: The ratios of central artery involvement,venous thrombosis of the lower extremity,persistent atrial fibrillation and embolism index in infarction group were all higher than non-infarction group(P < 0.05).The incidence rate of chronic obstructive pulmonary disease and pulmonary heart disease between the two groups had no statistical significance.Conclusion: The ratios of central artery involvement,venous thrombosis of the lower extremity,persistent atrial fibrillation and embolism index are important influential factors of pulmonary infarction after acute pulmonary embolism.The incidence rate of chronic obstructive pulmonary disease and pulmonary heart disease do not have obvious correlation with pulmonary infarction.CTA has important value in the diagnosis of pulmonary infarction and the differential diagnosis with hemorrhagic atelectasis and collapse of lung.