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目的应用多层螺旋CT对肺动脉高压及无肺动脉高压患者肺动脉树分支率和管径变化进行测量对比研究。方法 31例肺动脉高压患者和42例无肺动脉高压者分别进行肺动脉CTA检查和经胸超声心动图检查。应用图像后处理软件对肺动脉树的各级分支管腔进行测量,并计算各级肺动脉的分支率,对肺动脉高压和无肺动脉高压者肺动脉树各级分支的管腔直径和分支率分别进行对比研究。结果肺动脉高压者从肺动脉主干到第5级肺动脉管腔直径均大于无肺动脉高压者(t值分别为6.836、4.460、2.984、3.342、4.151、5.786,均P<0.01),到第6级肺动脉两者之间无明显统计学差异(t=1.347,P=0.198);肺动脉高压者从肺动脉主干分支率到第4级肺动脉分支率均小于无肺动脉高压者(t值分别为-2.787、-4.583、-3.145、-3.518、-2.695,均P<0.01),第5和6级肺动脉的分支率两者间无明显统计学差异(t值分别为0.442、-0.695,均P>0.05)。结论肺动脉高压者远端第6级肺动脉无扩张,与无肺动脉高压者比较第5和6级肺动脉分支率无变化。
Objective To compare the changes of pulmonary artery branch rate and diameter with multi-slice spiral CT in patients with pulmonary hypertension and non-pulmonary hypertension. Methods 31 patients with pulmonary hypertension and 42 patients without pulmonary hypertension were examined by CTA and transthoracic echocardiography respectively. Image postprocessing software was used to measure the branch lumen at all levels of the pulmonary artery tree. The branch rates of pulmonary arteries at all levels were calculated. The diameters of the lumen and the branch rates of the branches of the pulmonary artery tree in pulmonary hypertension and non-pulmonary hypertension were compared . Results Pulmonary hypertension from the main pulmonary artery to grade 5 pulmonary artery lumen diameter were greater than those without pulmonary hypertension (t values were 6.836,4.460,2.984,3.342,4.151,5.786, all P <0.01), to grade 6 pulmonary artery two (T = 1.347, P = 0.198). The rates of pulmonary artery branches from pulmonary artery to grade 4 pulmonary artery branches in patients with pulmonary hypertension were significantly lower than those without pulmonary hypertension (t = -2.787, -4.583, -3.145, -3.518, -2.695, all P <0.01). No significant difference was found in the grade of pulmonary artery between grade 5 and 6 (t = 0.442, -0.695, all P> 0.05). Conclusions There is no dilatation of the distal pulmonary artery in grade 6 in patients with pulmonary hypertension. There is no change in the grade of pulmonary artery in grade 5 and 6 in comparison with those without pulmonary hypertension.