摘要
目的:分析研究CT肺动脉造影(computed tomographic pulmonary angiography,CTPA)图像测量指标、B型脑钠肽(B-type brain natriuretic peptide,BNP)与急性肺动脉栓塞(acute pulmo-nary embolism,APE)患者危险分层及预后的关系.方法:纳入2020年1月至2023年6月蚌埠医科大学第一附属医院经CTPA扫描的APE患者86例,根据欧洲心脏病学会APE危险分层方法,将患者分为低危组(n=41)、中危组(n=27)和高危组(n=18).比较三组患者的CTPA图像测量指标(包括主肺动脉与胸升主动脉内径比值(PA/AO)、右心室与左心室内径比值(RVD/LVD)、上腔静脉直径(SVC)等)与外周血中BNP的水平;采用Spearman相关分析PA/AO、RVD/LVD、SVC、BNP水平与APE危险分层的关系;采用多因素Logistics回归分析APE患者预后不良的影响因素;绘制ROC曲线分析PA/AO、RVD/LVD、SVC、BNP水平对APE患者预后不良的预测价值.结果:三组APE患者的PA/AO、RVD/LVD、SVC、BNP指标均具有统计学意义(P＜0.05),且与APE危险分层均呈正相关(P＜0.05);多因素Logistics回归分析显示高危分层、PA/AO、RVD/LVD、SVC及BNP升高(OR=1.889、2.036、2.092、2.002、BNP及2.104)均是APE患者预后不良的独立危险因素(P＜0.05);ROC曲线分析显示PA/AO、RVD/LVD、SVC、BNP及联合检测的曲线下面积(AUC)分别为 0.776、0.862、0.883、0.907、0.987,联合检测优于单一检测(P＜0.05).结论:CTPA 图像测量指标、BNP水平与APE患者危险分层相关,对APE患者的预后评估具有一定价值.
Abstract
Objective:To analyze and study the relationship between computed tomographic pulmonary angiography(CTPA)Image Measurement Metrics,B-type brain natriuretic peptide(BNP),and risk stratification and prognosis of patients with acute pulmonary embolism(APE).Methods:Eighty-six patients with APE scanned by CTPA in the First Affiliated Hospital of Bengbu Medical University from January 2020 to June 2023 were included,and the patients were categorized into low-risk(n=41),intermediate-risk(n=27),and high-risk(n=18)groups according to the European Society of Cardiology APE risk stratification methodology.Comparison of CTPA Image Measurement Metrics[including the ratio of the internal diameters of the main pulmonary artery to the thoracic ascending aorta(PA/AO),the ratio of the internal diameters of the right ventricle to the left ventricle(RVD/LVD),and the diameter of the superior vena cava(SVC)]and the level of BNP in peripheral blood in the three groups of patients.Spearman correlation analysis was used to analyze the relationship between PA/AO,RVD/LVD,SVC,BNP level and risk stratification of APE.Death during hospitalization indicated poor prognosis.Multi-factor logistics regression was used to analyze the influencing factors of poor prognosis in APE patients.ROC curve was drawn to analyze the predictive value of PA/AO,RVD/LVD,SVC and BNP levels in poor prognosis of APE patients.Results:The indicators of PA/AO,RVD/LVD,SVC and BNP were statistically significant in all three groups of APE patients(P＜0.05)and positively correlated with APE risk stratification(P＜0.05);multifactorial logistic regression analysis showed that elevated risk stratification,PA/AO,RVD/LVD,SVC and BNP(OR=1.889,2.036,2.092,2.002,BNP and 2.104)were all independent risk factors for poor prognosis in APE patients(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of PA/AO,RVD/LVD,SVC,BNP and combined detection were 0.776,0.862,0.883,0.907 and 0.987,respectively,and combined detection was superior to single detection(P＜0.05).Conclusion:CTPA image measurement metrics and BNP are correlated with risk stratification in APE patients,and have certain value in the prognosis assessment of APE patients.
维普
万方数据