多层螺旋CT在老年急性肺栓塞诊断及疗效评估中的价值

Value of multislice spiral computed tomography in diagnosis and treatment of acute pulmonary embolism in the elderly

摘要:

目的 探讨CT肺动脉造影（CTPA）对老年急性肺栓塞（PE）的诊断及疗效评估价值。方法 入选2009年1月至2015年1月在复旦大学附属华东医院心内科住院的老年急性PE患者55例，分为严重组（n＝24）和非严重组（n＝31）。比较两组患者在溶栓治疗前后右/左心室短轴最大径比（RV/LV）、上腔静脉最大径、肺动脉最大径及栓塞指数等指标。结果 与溶栓治疗前相比，严重组患者的RV/LV、上腔静脉最大径、肺动脉最大径及栓塞指数在治疗后均显著降低，差异均具有统计学意义（P＜0.05）；非严重组患者的肺动脉最大径和栓塞指数在治疗后显著降低，差异均具有统计学意义（P＜0.05）。结论 CTPA可用于PE的诊断，并能对溶栓后疗效进行评价，具有快速、有效、无创的优势。

Abstract:

Objective To investigate the value of CT pulmonary angiography (CTPA) in the diagnosis and efficient assessment of pulmonary embolism (PE) in the elderly. Methods Fifty-five patients with acute PE admitted in Department of Cardiology in our hospital from January 2009 to January 2015 were enrolled in this study. They were divided into severe group (n＝24) and non-severe group (n＝31). Right/left ventricular short axis diameter ratio (RV/LV), superior vena cava and pulmonary artery diameter, and obstruction index were compared between the 2 groups before and after treatment. Results Compared with before treatment, RV/LV, superior vena cava and pulmonary artery diameter, and obstruction index were obviously decreased in the severe group (P＜0.05). But, for the non-severe group, only pulmonary artery diameter and obstruction index were significantly reduced after treatment (P＜0.05). Conclusion CTPA can be used for the diagnosis of PE, and it is a fast, effective, non-invasive way to evaluate the efficacy of thrombolysis treatment.