中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2012年
4期
264-268
,共5页
刘鹏%郭顺林%雷军强%窦郁%张娟丽
劉鵬%郭順林%雷軍彊%竇鬱%張娟麗
류붕%곽순림%뢰군강%두욱%장연려
体层摄影术,X线计算机%肺疾病,慢性阻塞性%高血压,肺性
體層攝影術,X線計算機%肺疾病,慢性阻塞性%高血壓,肺性
체층섭영술,X선계산궤%폐질병,만성조새성%고혈압,폐성
Tomography,X-ray computed%Pulmonary disease,chronic obstructive%Hypertension,pulmonary arterial
目的 探讨多层螺旋CT(MSCT)对COPD相关肺动脉高压的诊断价值.方法 纳入2011年1至11月在兰州大学第一医院行健康检查及就诊的100名健康成人及81例COPD患者,分别测量其肺动脉直径及面积,计算主肺动脉与升主动脉、降主动脉、胸椎及气管直径的比值,分析其与COPD相关肺动脉高压的关系,两样本均数比较采用t检验,多组均数比较使用单因素方差分析,两两比较使用SNK法,多样本率比较采用X2检验.结果 COPD组各项MSCT观察指标与对照组相匹配,分别按照年龄、病情严重程度及肺动脉收缩压将COPD患者细分为＜40岁组、40 ～ 60岁组和＞60岁组,Ⅰ级组、Ⅱ级组、Ⅲ级组和Ⅳ级组,肺动脉压＞50 mm Hg(1 mm Hg =0.133 kPa)组和≤50 mm Hg组,各亚组MSCT观察指标分别与对照组比较,差异均有统计学意义(均P＜0.05);COPD组主肺动脉直径[(3.14±0.63)cm]等与肺动脉收缩压呈正相关(均P＜0.05),主肿动脉直径与气管横径比值(1.81±0.48)等与FEV1占预计值％呈负相关(P＜0.05),各观察指标敏感度差异无统计学意义(x2=17.76,P ＞0.05).结论 MSCT在COPD相关肺动脉高压的诊断有着不可替代的优势,主肺动脉直径与气管横径的比值、主肺动脉横断面面积、主肺动脉直径与胸椎横径的比值可与既往指标一起作为诊断标准评价COPD相关肺动脉高压.
目的 探討多層螺鏇CT(MSCT)對COPD相關肺動脈高壓的診斷價值.方法 納入2011年1至11月在蘭州大學第一醫院行健康檢查及就診的100名健康成人及81例COPD患者,分彆測量其肺動脈直徑及麵積,計算主肺動脈與升主動脈、降主動脈、胸椎及氣管直徑的比值,分析其與COPD相關肺動脈高壓的關繫,兩樣本均數比較採用t檢驗,多組均數比較使用單因素方差分析,兩兩比較使用SNK法,多樣本率比較採用X2檢驗.結果 COPD組各項MSCT觀察指標與對照組相匹配,分彆按照年齡、病情嚴重程度及肺動脈收縮壓將COPD患者細分為＜40歲組、40 ～ 60歲組和＞60歲組,Ⅰ級組、Ⅱ級組、Ⅲ級組和Ⅳ級組,肺動脈壓＞50 mm Hg(1 mm Hg =0.133 kPa)組和≤50 mm Hg組,各亞組MSCT觀察指標分彆與對照組比較,差異均有統計學意義(均P＜0.05);COPD組主肺動脈直徑[(3.14±0.63)cm]等與肺動脈收縮壓呈正相關(均P＜0.05),主腫動脈直徑與氣管橫徑比值(1.81±0.48)等與FEV1佔預計值％呈負相關(P＜0.05),各觀察指標敏感度差異無統計學意義(x2=17.76,P ＞0.05).結論 MSCT在COPD相關肺動脈高壓的診斷有著不可替代的優勢,主肺動脈直徑與氣管橫徑的比值、主肺動脈橫斷麵麵積、主肺動脈直徑與胸椎橫徑的比值可與既往指標一起作為診斷標準評價COPD相關肺動脈高壓.
목적 탐토다층라선CT(MSCT)대COPD상관폐동맥고압적진단개치.방법 납입2011년1지11월재란주대학제일의원행건강검사급취진적100명건강성인급81례COPD환자,분별측량기폐동맥직경급면적,계산주폐동맥여승주동맥、강주동맥、흉추급기관직경적비치,분석기여COPD상관폐동맥고압적관계,량양본균수비교채용t검험,다조균수비교사용단인소방차분석,량량비교사용SNK법,다양본솔비교채용X2검험.결과 COPD조각항MSCT관찰지표여대조조상필배,분별안조년령、병정엄중정도급폐동맥수축압장COPD환자세분위＜40세조、40 ～ 60세조화＞60세조,Ⅰ급조、Ⅱ급조、Ⅲ급조화Ⅳ급조,폐동맥압＞50 mm Hg(1 mm Hg =0.133 kPa)조화≤50 mm Hg조,각아조MSCT관찰지표분별여대조조비교,차이균유통계학의의(균P＜0.05);COPD조주폐동맥직경[(3.14±0.63)cm]등여폐동맥수축압정정상관(균P＜0.05),주종동맥직경여기관횡경비치(1.81±0.48)등여FEV1점예계치％정부상관(P＜0.05),각관찰지표민감도차이무통계학의의(x2=17.76,P ＞0.05).결론 MSCT재COPD상관폐동맥고압적진단유착불가체대적우세,주폐동맥직경여기관횡경적비치、주폐동맥횡단면면적、주폐동맥직경여흉추횡경적비치가여기왕지표일기작위진단표준평개COPD상관폐동맥고압.
Objective To investigate the use of multislice spiral CT (MSCT) in the diagnosis of pulmonary arterial hypertension (PAH) in patients with chronic obstructive pulmonary disease (COPD).Methods The diameters and areas of the pulmonary artery were measured in 81 cases with COPD and 100 normal adults from January to November 2011. The ratios of the diameters of the main pulmonary artery (MPA) to ascending aorta ( AA ),descending aorta (DA),trachea,thoracic vertebra ( ThV ) were also calculated.Data analysis used the t test of the 2 samples compared,multi-rate compared by x2 test.Results There were significant differences in the measured parameters between the COPD group and the control group.The differences were also significant among groups of COPD patients aged ＜ 40 y,40 - 60 y, ＞ 60 y,and the control group,among patients with different stages of COPD (stage Ⅰ, Ⅱ,Ⅲ,Ⅳ ) and the control group,and among patients with sPAP ＞50 mm Hg ( 1 mm Hg =0.133 kPa),sPAP≤50 mm Hg and the control group.There were positive correlations between sPAP and the measured indexes such as MPA [ (3.14 ± 0.63 )cm]of pulmonary artery in COPD.There were negative correlations between FEV1 ％ and some of the measured indexes such as MPA/Td ( 1.81 ± 0.48 ).Multi-indicators was no significant difference (x2 =17.76,P ＞0.05).Conclusions MSCT is very useful in diagnosis of PAH in COPD.The diameter ratio of MPA to trachea,the area of MPA,and the diameter ratio of MPA to ThV can be used as diagnostic criteria for evaluation of PAH in COPD.
