摘要
目的探讨胸部CT的右心室、左心室容积比(RVv/LVv)和超声心动图(UCG)的肺动脉收缩压(PASP)在肺动脉高压(PAH)诊断中的价值。方法回顾性分析2015年2月-2017年7月在该院初诊的136例疑似PAH患者的临床资料,以右心导管检查(RHC)结果为金标准,比较RVv/LVv及PASPUCG在PAH诊断中的准确率。结果 136例疑似PAH患者中,102例为PAH患者,34例为非PAH患者。两组PASPRHC、RVv/LVv比较,差异有统计学意义(P<0.05),RVv/LVv、PASPUCG与PASPRHC呈正相关(P<0.05),采用受试者工作特征曲线获得RVv/LVv、PASPUCG最佳临界值(0.86、40 mmHg)。若以此为分组依据,RVv/LVv的诊断敏感性、特异性、准确率分别为89.4%(95%CI:81.4%,94.3%)、88.2%(95%CI:71.6%,96.2%)和89.0%(95%CI:80.2%,95.7%);PASPUCG为91.1%(95%CI:83.5%,95.6%)、85.3%(95%CI:68.2%,94.5%)和89.7%(95%CI:85.6%,97.2%);两者联用为98.0%(95%CI:92.4%,99.7%)、85.3%(95%CI:68.2%,94.5%)和94.9%(95%CI:88.9%,98.9%)。结论 RVv/LVv、PASPUCG在PAH早期诊断中有较好的诊断效能,若两者联合可进一步提高诊断准确率。
Objective To investigate the clinical value of right ventricular to left ventricular volume ratio(RVv/LVv)and echocardiographic(UCG)pulmonary artery systolic pressure(PASP)in the diagnosis of pulmonary artery hypertension(PAH).Methods A retrospective analysis was conducted on 136 patients of suspected PAH newly diagnosed in our hospital from February 2015 to July 2017.Taking the results of right heart catheterization(RHC)as the gold standard of diagnosis,the accuracy of RVv/LVv and PASPUCG in PAH diagnosis was observed.Results Among the 136 suspected PAH patients,102 were PAH patients and 34 were non-PAH patients.There were significant differences in PASPRHC and RVv/LVv between the two groups(P<0.05),while RVv/LVv and PASPUCG were positively associated with PASPRHC(P<0.05).The best critical values of RVv/LVv and PASPUCG obtained by ROC were 0.86 and 40 mmHg respectively.The diagnostic sensitivity,specificity and accuracy of RVv/LVv were 89.4%(95%CI:0.814,0.943),88.2%(95%CI:0.716,0.962)and 89.0%(95%CI:0.802,0.957),respectively;those of PASPUCG were 91.1%(95%CI:0.835,0.956),85.3%(95%CI:0.682,0.945)and 89.7%(95%CI:0.856,0.972)respectively;and those of the combination of the two were 98.0%(95%CI:0.924,0.997),85.3%(95%CI:0.682,0.945)and 94.9%(95%CI:0.889,0.989)respectively.Conclusions RVv/LVv and PASPUCG have better diagnostic efficacy in the early diagnosis of pulmonary hypertension,their combination can further improve the diagnostic accuracy.
作者
王伟芳
杜薇
丁智超
Wei-fang Wang;Wei Du;Zhi-chao Ding(Department of Ultrasonography,Chengde City Central Hospital,Chengde,Hebei 067000,China;Medical Examination Center,Chengde City Central Hospital,Chengde,Hebei 067000,China;Department of Radiology,Chengde City Central Hospital,Chengde,Hebei 067000,China)
出处
《中国现代医学杂志》
CAS
2018年第32期77-81,共5页
China Journal of Modern Medicine
基金
河北省承德市科技支撑计划项目(No:20132006)
关键词
肺动脉高压
超声心动图
右、左心室体积比
肺动脉收缩压
pulmonary hypertension
echocardiography
right ventricular volume/left ventricular volume
pulmonary artery systolic pressure
