本文選題：慢性阻塞性肺疾病　切入點(diǎn)：肺動(dòng)脈主干　出處：《山西醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的： 探究主肺動(dòng)脈直徑(MPA)、主肺動(dòng)脈直徑/升主動(dòng)脈直徑(rPAA)、主肺動(dòng)脈直徑/降主動(dòng)脈直徑(rPDA)、右下肺動(dòng)脈直徑(RIPA)及段動(dòng)脈/伴行支氣管直徑(dA/B)對(duì)慢性阻塞性肺疾病(COPD)相關(guān)性肺動(dòng)脈高壓(PH)的診斷價(jià)值。 資料與方法： 收集經(jīng)臨床確診為COPD、且懷疑伴有肺動(dòng)脈高壓的患者60例,并全部行超聲心動(dòng)圖(UCG)及MSCT胸部平掃檢查。在MSCT掃描預(yù)定層面上測量并計(jì)算MPA、rPAA、rPDA、RIPA及dA/B。以MPA29mm、rPAA1、rPDA1、 RIPA15mm、或者至少3/4個(gè)肺葉的dA/B1作為MSCT診斷肺動(dòng)脈高壓的依據(jù),并同時(shí)觀察肺實(shí)質(zhì)及右心的變化情況。將肺動(dòng)脈收縮壓(PASP)分別與MPA、 rPAA、rPDA、RIPA及4個(gè)段dA/B進(jìn)行相關(guān)性分析,對(duì)MSCT圖像所測上述指標(biāo)與UCG診斷PH進(jìn)行一致性檢驗(yàn),分析在MSCT圖像上用哪一個(gè)指標(biāo)診斷PH與UCG診斷PH的一致性較好。 結(jié)果： MPA、rPAA與肺動(dòng)脈收縮壓呈明顯相關(guān)性(r=0.699,P0.05和r=0.510,P0.05),其它指標(biāo)(rPDA、RIPA、4個(gè)段dA/B)與肺動(dòng)脈收縮壓沒有明顯相關(guān)性。以MPA或rPAA這兩個(gè)指標(biāo)診斷PH,與超聲心動(dòng)圖診斷PH具有很好的一致性(Kappa0.7),差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論： 1.MSCT是診斷COPD相關(guān)性肺動(dòng)脈高壓的好的影像學(xué)方法,具有很高的臨床實(shí)用價(jià)值。 2."MPA29mm"和"rPAA1"是診斷COPD相關(guān)性肺動(dòng)脈高壓的可靠指標(biāo)。 3.rPDA、RIPA和dA/B與PASP無明顯相關(guān)性。
[Abstract]:Objectives of the study:. To investigate the effects of main pulmonary artery diameter (MPAA), aorta diameter / ascending aorta diameter (RPAA), aorta diameter / descending aorta diameter (RPDAA), right inferior pulmonary artery diameter (RIPAA) and segmental artery / accompanied bronchi diameter (na / B) on chronic obstructive pulmonary disease (COPD). The diagnostic value of pulmonary hypertension (PHH). Information and methods:. A total of 60 patients with suspected pulmonary hypertension, who were clinically diagnosed as COPDs, were collected. All patients were examined by echocardiography (UCG) and MSCT chest plain scan. RIPA and da / B were measured and calculated on the predefined plane of MSCT scan. DA/B1 of MPA29mm rPAA1rPDA1, RIPA15mm, or at least 3/4 lobes of lung were used as the basis for the diagnosis of pulmonary hypertension. At the same time, the changes of pulmonary parenchyma and right heart were observed. The pulmonary artery systolic pressure (PASP) was correlated with MPA, rPAA, rPDARIPA and four segments of dA/B, respectively, and the consistency between the above indexes measured on MSCT images and the diagnosis of PH in UCG was checked. To analyze which index to diagnose PH on MSCT image is consistent with that of UCG. Results:. MPA-rPAA was significantly correlated with pulmonary arterial systolic blood pressure (PAP) (P 0.05) and RPA (0. 510) P 0. 05 (P < 0 05). There was no significant correlation between pulmonary arterial systolic blood pressure (PAP) and pulmonary arterial systolic blood pressure (PAP). The diagnosis of pulmonary artery systolic blood pressure (PAP) by MPA or rPAA was in good agreement with the diagnosis of PH by echocardiography (P < 0. 05) and Kappa 0. 7% (P < 0. 05). The difference was not statistically significant (P 0.05). Conclusion:. 1. MSCT is a good imaging method for the diagnosis of COPD associated pulmonary hypertension. 2. MPA29mm and rPAA1 are reliable markers for the diagnosis of COPD associated pulmonary hypertension. 3. RPDAA RIPA and dA/B had no significant correlation with PASP.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R544.1;R816.41

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 邱建國;潘解萍;喻少波;邢偉;單飛;丁玖樂;;多層螺旋CT在診斷結(jié)締組織病肺間質(zhì)病變致肺動(dòng)脈高壓中的價(jià)值[J];中國CT和MRI雜志;2011年02期

2 張剛;李建生;;MSCT在慢性阻塞性肺疾病研究中的應(yīng)用[J];中國中西醫(yī)結(jié)合影像學(xué)雜志;2011年03期

3 謝萬木;王辰;;肺動(dòng)脈高壓的定義分類與治療探討[J];中國實(shí)用內(nèi)科雜志;2010年04期

4 蔡柏薔;;慢性阻塞性肺疾病合并肺動(dòng)脈高壓診治的新認(rèn)識(shí)[J];中國實(shí)用內(nèi)科雜志;2010年12期

5 李敏;郝青林;何瑾;;COPD合并肺動(dòng)脈高壓發(fā)病機(jī)制的研究進(jìn)展[J];中國現(xiàn)代醫(yī)藥雜志;2011年01期

6 宋蘭;張竹花;金征宇;;多層螺旋CT無創(chuàng)冠狀動(dòng)脈成像的臨床應(yīng)用和進(jìn)展[J];中國醫(yī)學(xué)科學(xué)院學(xué)報(bào);2006年01期

，

本文編號(hào)：1608812