介入下肺动脉造影血管测量参数在慢性血栓 栓塞性肺动脉高压中的应用价值

Objective To investigate the value of pulmonary angiography-related vascular measurement parameters in predicting chronic pulmonary thromboembolic pulmonary hypertension．Methods Forty-two patients who underwent pulmonary angiography were all from the Department of Respiratory and Critical Care Medicine of the First People's Hospital of Kunming ， hospitalized during June 2017 to January 2019， and their clinic data were retrospectively analyzed. Among them， Twenty patients with a clear diagnosis of chronic thromboembolic pulmonary hypertension which means Pulmonary systolic pressure （PASP） > 30 mmHg （1 mmHg = 0.133 kPa） were included in the study group. Twenty-two patients without pulmonary embolism served as a control group with pulmonary systolic blood pressure（PASP） < 25 mmHg. WE measured the diameters of the main pulmonary artery，the right pulmonary artery trunk，and the left pulmonary artery trunk on the DSA image. The difference between the measured vascular diameters of the study group and the control group was analyzed by T test， and the statistically significant vascular parameters were analyzed by ROC curve to assess the specificity and sensitivity of each group of vascular parameters for the diagnosis and prediction of pulmonary hypertension．Results In the control group， the diameter of the main pulmonary artery， the diameter of the right pulmonary artery， and the diameter of the left pulmonary artery were（26.38 ±2.82） mm， （20.66±1.74 mm）， and （19.79 ± 1.6） mm， respectively，which were smaller than those in the study group （33.80±4.13）mm， （28.79±3.28） mm， （24.85±2.97） mm，and the difference values were statistically significant（ < 0.001） . The areas of the pulmonary artery in each group was 0.901，0.989，and 0.924 （ < 0.001） under the ROC curve. The sensitivity of the three groups was similar in the diagnosis and prediction of pulmonary hypertension，but the diameter of the right pulmonary artery had highest specificity．Conclusion Interventional pulmonary angiography used as a gold standard for the diagnosis of pulmonary embolism can be used to measure and predict pulmonary hypertension by measuring vascular parameters such as main pulmonary artery diameter， right pulmonary artery diameter，and left pulmonary artery diameter. It can provide help for clinical evaluation and a better treatment plan selection. [ABSTRACT FROM AUTHOR]