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目的评估Qanadli等提出的CT阻塞指数在定量分析肺动脉栓塞(pulmonary embolism,PE)患者治疗效果中的价值。资料与方法经多层螺旋CT血管成像(CTA)确诊、经溶栓或(及)抗凝治疗并治疗后以CTA随访的患者55例,随访时间为1~6周。治疗前后采用Qanadli栓塞指数评价PE程度,并采用Spearman等级相关系数评价其与临床指征(血氧饱和度及肺动脉压)恢复的相关性。结果 55例患者中,51例经溶栓或(及)抗凝治疗后临床指征明显改善,血氧饱和度由(83.52±4.461)%上升到(94.76±3.532)%(P<0.001),肺动脉压力由(31.17±5.892)mmHg(1 mmHg=0.133 kPa)下降至(19.83±4.804)mmHg(P<0.001);Qanadli栓塞指数从治疗前的(45.09±18.22)%降至治疗后的(10.86±10.29)%(P<0.001)。4例临床指征改善不明显,Qanadli栓塞指数治疗前后差异无显著统计学意义(P=0.080)。治疗前后Qanadli栓塞指数与血氧饱和度、肺动脉压力的差异度均存在良好相关性(r值分别为0.934、0.813)。结论 Qanadli栓塞指数可准确用于PE治疗效果的定量评估,对临床治疗方案的制定有指导作用。
Objective To assess the value of Qanadli et al.’s CT block index in quantitative analysis of the therapeutic effect of pulmonary embolism (PE). Materials and Methods 55 patients who were confirmed by multi-slice spiral CT angiography (CTA) and followed up by CTA after thrombolytic or (and) anticoagulation therapy were followed up for 1-6 weeks. Before and after treatment, Qanadli embolization index was used to evaluate the degree of PE. Spearman rank correlation coefficient was used to evaluate the correlation between PE and clinical indications (oxygen saturation and pulmonary arterial pressure). Results Among the 55 patients, the clinical indications of 51 patients were significantly improved after thrombolysis and / or anticoagulation. The oxygen saturation increased from 83.52 ± 4.461% to 94.76 ± 3.532% (P <0.001) Pulmonary artery pressure decreased from (31.17 ± 5.892) mmHg (1 mmHg = 0.133 kPa) to (19.83 ± 4.804) mmHg (P <0.001), and Qanadli embolism index decreased from 45.09 ± 18.22% before treatment to 10.86 after treatment ± 10.29)% (P <0.001). No significant improvement was found in 4 cases. There was no significant difference in Qanadli embolism index before and after treatment (P = 0.080). Before and after treatment Qanadli embolism index and oxygen saturation, pulmonary artery pressure differences have a good correlation (r values were 0.934,0.813). Conclusion Qanadli embolism index can be accurately used in the quantitative evaluation of the therapeutic effect of PE, which can guide the formulation of clinical treatment.