肺栓塞:エコーカーディオグラフィー・ドップラーと5年生存分析による1年間の追跡調査
A Ribeiro1, P Lindmarker, H Johnsson
1Departments of Clinical Physiology, Haematology and Cardiovascular Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden. ari@thfys.ks.se
Circulation
|March 17, 1999
まとめ
肺栓塞 (PE) の予後は,肺高血圧 (PH) と右心室 (RV) の機能に依存する. 6週目のエコー・ドップラー画像は,患者のより良い管理のために,持続的なPH/RV機能不全を特定することができます.
科学分野:
- 心臓病学 心臓病学
- 肺内医学 肺内医学 肺内医学
- 診断用イメージング
背景:
- 肺栓塞 (PE) の予後は,基礎疾患である肺高血圧 (PH) と右心室 (RV) 機能不全によって影響を受けます.
- 肺動脈シストリック圧力 (PAsP) とRV機能の正確な追跡は,急性PE患者の持続的なPH/RV機能不全を特定するために重要である.
- 持続的なPH/RV機能障害の危険因子と生存率を特定することは,患者の管理に不可欠です.
研究 の 目的:
- 急性PE後のPAsPとRV機能の時間経過を記述する.
- 持続的なPH/RV機能不全に関連する変数を特定する.
- 急性PE患者の5年生存率を分析する.
主な方法:
- エコーカルディオグラフィー・ドップラー検査は,急性PE患者の78人に診断時に,そして1年以上にわたって繰り返し行われました.
- リスク因子と5年後の死亡率を分析するために複数のロジスティック回帰モデルが使用されました.
- 5年生存分析は,入院後1ヶ月で生存している患者について行われました.
主要な成果:
- PAsPは指数関数的に低下し,38日以内に安定し,RV機能の回復と一致しました.
- 診断時のPAsP>50mmHgは,1年後にPHの持続を予測した.
- 基礎疾患は5年死亡率と相関する; 持続的なPHを有する患者のみが5年以内に肺血栓内膜切除を必要とした.
結論:
- 急性PE診断後の6週間のドップラー心声検査は,持続的なPH/RV機能不全を効果的に特定します.
- このイメージング技術は,影響を受けた患者のフォローアップとケアを計画するのに役立ちます.
- 持続的なPH/RV機能障害の早期発見は,治療決定を導き,治療結果を改善することができます.
関連する概念動画
Pneumothorax-I
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax-II
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
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