CAJ | 학술논문

目的：探讨胸部CT定量指标对重症急性胰腺炎（SAP）并发急性肺损伤（ALI）/急性呼吸窘迫综合征（ARDS）的早期诊断价值。方法：收集我院69例SAP病例，其中34例合并ALL/ARDS。在胸部CT纵隔窗分别测量两侧肺实变、胸水和胸腔的厚度及其比值，分析评估其对ALL/ARDS的诊断价值。结果：左侧肺实变/胸腔厚度、左侧胸水/胸腔厚度、左侧肺实变/胸水厚度、右侧肺实变/胸腔厚度、右侧胸水/胸腔厚度和右侧肺实变/胸水厚度等定量指标，在SAP有无并发ALI/ARDS组间的差异均具有统计学意义（P=0.000～0.019）。R0C曲线分析显示左侧肺实变/胸腔厚度、左侧肺实变/胸水厚度、右侧肺实变/胸腔厚度对于SAP患者并发ALI/ARDS的诊断价值更高，其阳性似然比分别为5.158、3.970和3.530，该三项指标平行试验显示其诊断灵敏度高达99.4%。结论：胸部CT定量测量指标对SAP并发ALI/ARDS的早期诊断具有重要的参考价值，可望为ALI/ARDS的早期治疗提供依据。
목적：탐토흉부CT정량지표대중증급성이선염（SAP）병발급성폐손상（ALI）/급성호흡군박종합정（ARDS）적조기진단개치。방법：수집아원69례SAP병례，기중34례합병ALL/ARDS。재흉부CT종격창분별측량량측폐실변、흉수화흉강적후도급기비치，분석평고기대ALL/ARDS적진단개치。결과：좌측폐실변/흉강후도、좌측흉수/흉강후도、좌측폐실변/흉수후도、우측폐실변/흉강후도、우측흉수/흉강후도화우측폐실변/흉수후도등정량지표，재SAP유무병발ALI/ARDS조간적차이균구유통계학의의（P=0.000～0.019）。R0C곡선분석현시좌측폐실변/흉강후도、좌측폐실변/흉수후도、우측폐실변/흉강후도대우SAP환자병발ALI/ARDS적진단개치경고，기양성사연비분별위5.158、3.970화3.530，해삼항지표평행시험현시기진단령민도고체99.4%。결론：흉부CT정량측량지표대SAP병발ALI/ARDS적조기진단구유중요적삼고개치，가망위ALI/ARDS적조기치료제공의거。
Objective:To explore the early diagnostic value of quantitative index of thoracic CT in severe acute pancreatitis complicated with ALI/ARDS. Methods: Sixty-nine cases of severe acute pancreatitis were collected, 34 cases complicated with ALI/ARDS. The thickness of bilateral lung consolidation, pleural lfuid and thoracic cavity were measured and the ratio of them on CT mediastinal window was calculated, respectively, and then evaluate their diagnostic value for ALI/ARDS. Results:There were statistical signiifcance of difference between SAP complicated with ALI/ARDS and SAP upon every quantitative index (the thickness ratio of left lung consolidation to thoracic cavity, the thickness ratio of left lung consolidation to pleural lfuid, the thickness ratio of left pleural lfuid to thoracic cavity, the thickness ratio of right lung consolidation to thoracic cavity, the thickness ratio of right lung consolidation to pleural lfuid and the thickness ratio of right pleural lfuid to thoracic cavity). ROC curve showed that three indexes (the thickness ratio of left lung consolidation to thoracic cavity, the thickness ratio of left lung consolidation to pleural lfuid and the thickness ratio of consolidation of right lung to thoracic cavity, with positive likelihood ratio of 5.158, 3.970 and 3.530) had greater diagnostical value for SAP complicated with ALI/ARDS than others. With these three indexes, the sensitivity was 0.994 by parallel test. Conclusion:Quantitative indexes of thoracic CT have important reference for early diagnosis of SAP compli-cated with ALI/ARDS and can provide proof for early therapy.