【摘要】 目的 探究多层螺旋CT肺动脉成像(MS-CTPA)中定量参数对急性肺动脉栓塞(APE)患者危险程度的预测价值，并分析该参数与APE患者危险程度的相关性。方法 回顾性分析河南省胸科医院2021年6月至2024年6月接收的100例APE患者资料，患者均接受MS-CTPA检查并借助肺栓塞严重指数(PESI)评估危险程度，据此将患者分为低危组与中-高危组，比较两组MS-CTPA中定量参数差异，观察MS-CTPA中定量参数与APE患者危险程度的相关性，同时绘制列线图、校准曲线及受试者工作特征(ROC)曲线分析MS-CTPA中定量参数对于APE患者危险程度的预测价值。结果 研究纳入100例APE患者，31例患者纳入低危组(31.00%)，余下69例患者，均纳入中-高危组(69.00%)。低危组肺动脉主干最大内径(DPA)、主肺动脉及胸主动脉内径比值(PA/AO)、上腔静脉直径(SVC)、右心室与左心室短轴最大径比值(RVD/LVD)水平均低于中-高危组(P<0.05);相关性分析显示，APE患者PESI与DPA、PA/AO、SVC、RVD/LVD之间呈正相关关系(r=0.499、0.509、0.500、0.514,P<0.05);构建APE患者危险程度的列线图风险预测模型并绘制校准曲线，发现Calibration校准曲线显示，校准曲线接近于理想曲线，P值高达0.869、拟合效果较好，同时绘制ROC曲线验证模型预测效能，发现该模型预测APE患者危险程度的ROC曲线下面积(AUC)值为0.975(95%CI:0.951～0.999)。结论 APE患者PESI与MS-CTPA中定量参数存在显著相关性，DPA、PA/AO、SVC、RVD/LVD可作为APE患者危险程度的预测指标，为临床治疗方案选择提供重要依据。更多还原

【Abstract】 Objective To investigate the predictive value of quantitative parameters in multi-slice spiral CT pulmonary angiography(MS-CTPA) for risk stratification of acute pulmonary embolism(APE) patients and analyze their correlations with clinical risk.Methods The data of 100 patients with APE received by Henan Chest Hospital from June 2021 to June 2024 were retrospectively analyzed.All patients underwent MS-CTPA examination and the risk degree was evaluated by pulmonary embolism severity index(PESI).According to this,the patients were divided into low-risk group and medium-high-risk group.The differences of quantitative parameters in MS-CTPA between the two groups were compared,and the correlation between quantitative parameters in MS-CTPA and the risk degree of APE patients was observed.At the same time,the nomogram,calibration curve and receiver operating characteristic(ROC) curve were drawn to analyze the predictive value of quantitative parameters in MS-CTPA for the risk degree of APE patients.Results A total of 100 patients with APE were included in the study,31 patients were included in the low-risk group(31.00%),and the remaining 69 patients were included in the medium-high-risk group(69.00%).The maximum diameter of the main pulmonary artery(DPA),the ratio of the main pulmonary artery to the thoracic aorta(PA/AO),superior vena cava diameter(SVC),and right ventricular dimension to left ventricular dimension ratio(RVD/LVD) in the low-risk group were lower than those in the medium-high-risk group(P<0.05).Correlation analysis showed that there was a positive correlation between PESI and DPA,PA/AO,SVC,RVD/LVD in APE patients(r=0.499,0.509,0.500,0.514,P<0.05).The nomogram risk prediction model of the risk degree of APE patients was constructed and the calibration curve was drawn.It was found that the calibration curve was close to the ideal curve,the P value was as high as 0.869,and the fitting effect was good.At the same time,the ROC curve was drawn to verify the prediction efficiency of the model.It was found that area under the curve(AUC) value of the model to predict the risk degree of APE patients was 0.975(95% CI: 0.951-0.999).Conclusion Quantitative MS-CTPA parameters(DPA,PA/AO,SVC,RVD/LVD) strongly correlate with PESI and serve as reliable predictors for APE risk stratification,offering critical guidance for clinical decision-making.更多还原