【摘要】 目的 探讨不同部位下肢深静脉血栓形成（DVT）与急性肺血栓栓塞症（APTE）后肺动脉主干（MPA）宽度、右室流出道（RVOT）宽度、右心室内径（RVID）的相关性。方法 收集2019年5月至2021年5月于承德医学院附属医院初诊为APTE的83例患者的临床资料，按照DVT部位的不同将患者分为4组，分别为下腔髂静脉型血栓组（n=15，髂外静脉、髂内静脉、髂总静脉、下腔静脉）、小腿肌间静脉型血栓组（n=26）、股腘静脉型血栓组（n=10，股静脉、腘静脉）和胫腓静脉型血栓组（n=32，胫前静脉、胫后静脉、腓静脉）。比较不同组别的MPA宽度、RVID、RVOT宽度，分析不同部位下肢DVT与APTE后MPA宽度、RVOT宽度、RVID的相关性。结果 4组患者的MPA宽度、RVID、RVOT宽度比较，差异均有统计学意义（P<0.05）。小腿肌间静脉型血栓组患者的MPA宽度、RVOT宽度、RVID均高于胫腓静脉型血栓组患者，但差异均无统计学意义（P>0.05）；与其他两组患者相比，小腿肌间静脉型血栓组患者的MPA宽度、RVOT宽度、RVID均明显升高，差异均有统计学意义（P<0.05）。下腔髂静脉型血栓组与股腘静脉型血栓组患者的MPA宽度、RVOT宽度、RVID比较，差异均无统计学意义（P>0.05）；与其他两组患者相比，下腔髂静脉型血栓组患者的MPA宽度、RVOT宽度、RVID均明显降低，差异均有统计学意义（P<0.05）。不同部位下肢DVT与APTE后MPA宽度、RVOT宽度、RVID均呈正相关（P<0.05），其中，小腿肌间静脉型血栓与MPA宽度、RVOT宽度、RVID的相关性最高，下腔髂静脉型血栓与MPA宽度、RVOT宽度、RVID的相关性最低。结论 不同部位下肢DVT与APTE后MPA宽度、RVOT宽度、RVID均呈正相关，小腿肌间静脉型血栓与MPA宽度、RVID、RVOT宽度的相关性最高。MPA宽度、RVOT宽度、RVID可作为APTE后肺动脉高压的预测指标之一。更多还原

【Abstract】 Objective To explore the correlation of deep venous thrombosis(DVT) in different parts of lower extremity with main pulmonary artery(MPA) width, right ventricular outflow tract(RVOT) width and right ventricular internal dimension(RVID) after acute pulmonary thromboembolism(APTE). Method The clinical data of 83 patients with initial APTE in Affiliated Hospital of Chengde Medical University from May 2019 to May 2021 were collected. The patients were divided into the inferior iliac vein thrombosis group(n=15, external iliac vein, internal iliac vein, common iliac vein, inferior vena cava), calf intermuscular vein thrombosis group(n=26), femoral popliteal vein thrombosis group(n=10, femoral vein, popliteal vein) and tibiofibular vein thrombosis group(n=32, anterior tibial vein, posterior tibial vein, peroneal vein) according to location of DVT. MPA width, RVID and RVOT width of DVT in different groups were compared and the correlation of DVT in different parts of lower extremity with MPA width, RVOT width and RVID after APTE was analyzed. Result There were significant differences for the MPA width, RVID and RVOT width of the four groups(P<0.05). MPA width, RVOT width and RVID in the calf intermuscular vein thrombosis group were higher than those in the tibiofibular vein thrombosis group, but without significant difference(P>0.05); compared with the other two groups, MPA width, RVOT width and RVID were increased in the calf intermuscular vein thrombosis group, and the differences were statistically significant(P<0.05). There was no significant difference between the inferior iliac vein thrombosis group and femoral popliteal vein thrombosis group(P>0.05); compared with other groups, MPA width, RVOT width and RVID were decreased in the inferior iliac vein thrombosis group, and the differences were statistically significant(P<0.05). DVT in different parts of the lower extremity were positively correlated with MPA width, RVOT width and RVID after APTE(P<0.05), with the highest correlation of calf intermuscular vein thrombosis with MPA width, RVOT width and RVID and lowest correlation of inferior iliac vein thrombosis with MPA width, RVOT width and RVID. Conclusion DVT in different parts of lower extremity is positively correlated with MPA width, RVOT width and RVID after APTE, with the highest correlation of calf intermuscular vein thrombosis with MPA width, RVOT width and RVID. MPA width, RVOT width and RVID can be used as one of the predictors of pulmonary hypertension after APTE.更多还原