【摘要】 目的分析超声心动图与胸部CT在诊断慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并肺动脉高压(pulmonary arterial hypertension,PAH)分级的临床价值。方法选择我院2015年7月至2017年6月收治的COPD合并PAH患者120例,均进行超声心动图与胸部CT检查,根据超声心动图PAH分级检查结果将患者分为轻度、中度和重度组,比较三组胸部CT图像中右下肺动脉横径及其与气管比值、主肺动脉直径、左肺动脉直径、右肺动脉直径,CT图像异常表现情况(肺动脉突出≧3mm、残根征及右心影增大)。结果三组右下肺动脉横径及其与气管比值均存在差异(P<0.05),右下肺动脉横径及其与气管比值比较:重度组>中度组>轻度组(P<0.05)。三组主肺动脉直径、左肺动脉直径、右肺动脉直径均存在差异(P<0.05),主肺动脉直径、左肺动脉直径、右肺动脉直径比较:重度PAH组>中度PAH组>轻度PAH组(P<0.05)。三组残根征发生率及右心影增大发生率均存在差异(P<0.05),肺动脉突出≥3mm发生率不存在差异(P>0.05);其中重度PAH组残根征发生率、右心影增大发生率显著大于轻度PAH组(P<0.05)。结论超声心动图、胸部CT有助于COPD合并PAH的分级诊断。更多还原

【Abstract】 Objective To analyze the clinical values of echocardiogram and chest CT in the diagnosis of chronic obstructive pulmonary disease(COPD) with pulmonary arterial hypertension(PAH) grades. Methods A total of 120 cases of COPD with PAH patients treated in our hospital from July 2015 to June 2017 were selected and were given the echocardiogram and chest CT examination. According to the results of echocardiogram PAH grades, the patients were divided into the mild PAH group, the moderate PAH group and the severe PAH group. The lower right pulmonary artery transverse diameter in chest CT images and its ratio with the trachea, main pulmonary artery diameter, the left pulmonary artery diameter and right pulmonary artery diameter, CT images abnormal situation(bulging pulmonary artery≧3 mm, residual root sign and right ventricular enlargement). Results There were differences in the lower right pulmonary artery transverse diameter and its ratio with trachea among the three groups(P<0.05), and the transverse diameter and its ratio with trachea showed that the severe PAH group > moderate PAH group > mild PAH group(P<0.05). The diameters of the main pulmonary artery, the left pulmonary artery and the right pulmonary artery were significantly different among the three groups(P<0.05), and the diameters showed that the severe PAH group > moderate PAH group > mild PAH group(P<0.05). There were significant differences in the incidence rates of residual root sign and right ventricular enlargement among the three groups(P<0.05), and there was no difference in the bulging pulmonary artery≧3 mm(P>0.05). And the incidence rate of residual root sign and right ventricular enlargement in the severe PAH group were significantly higher than those in the mild PAH group(P<0.05). Conclusion Echocardiogram and chest CT helps to the grading diagnosis of COPD combine with PAH.更多还原