Nowroozpoor Armin, Hshemian Seyed Mohammadreza, Malekmohammad Majid, Marjani Majid, Tabarsi Payam, Jamaati Hamidreza, Khoundabi Batoul, Moniri Afshin
Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Mycobacteriol. 2016 Dec;5 Suppl 1:S56. doi: 10.1016/j.ijmyco.2016.10.032. Epub 2016 Nov 25.
OBJECTIVE/BACKGROUND: Pulmonary hypertension (PH) can be a complication of patients with severe pulmonary tuberculosis (TB). We aimed to study the correlation between pulmonary artery (PA) diameter (PAD) as measured by computed tomography (CT) and mean PA pressure (mPAP) as measured by echocardiography. We also aimed to determine the accuracy of PAD in diagnosing PH in patients with pulmonary TB.
We retrospectively investigated the correlation between PAD measured using CT and mPAP measured using echocardiography in 132 patients with TB and PH, and 68 patients with TB but without PH, admitted to the TB intensive care unit at Masih Daneshvari Hospital in Tehran, Iran. We used logistic regression analysis to determine the relationships between PAD, PA diameter to ascending aorta (AA) ratio, and area of PA to area of AA ratio with mPAP. Using receiver operating characteristic analysis, we examined the utility of the PAD in predicting PH (mPAP ⩾25mmHg).
PAD had a significant correlation with mPAP (p<0.005 and r=0.47). Also, PA:AA ratio and area of PA to area of AA ratio had significant correlation with mPAP (r=0.48 and r=0.47, respectively; p<0.001). The threshold of 29mm for PAD was determined using ROC. This index had a sensitivity of 0.55, specificity of 70.2 and area under curve of 0.66.
Although PAD and PA:AA ratio are useful in assessing of presence of PH, we conclude that these CT parameters are not sufficient for ruling in or ruling out PH in this group of patients.
目的/背景：肺动脉高压（PH）可能是重症肺结核（TB）患者的一种并发症。我们旨在研究计算机断层扫描（CT）测量的肺动脉（PA）直径（PAD）与超声心动图测量的平均肺动脉压（mPAP）之间的相关性。我们还旨在确定PAD在诊断肺结核患者PH中的准确性。
我们回顾性研究了伊朗德黑兰马西赫·达内什瓦里医院结核病重症监护病房收治的132例肺结核合并PH患者和68例肺结核但无PH患者中，CT测量的PAD与超声心动图测量的mPAP之间的相关性。我们使用逻辑回归分析来确定PAD、PA直径与升主动脉（AA）比值以及PA面积与AA面积比值与mPAP之间的关系。使用受试者工作特征分析，我们检验了PAD在预测PH（mPAP⩾25mmHg）方面的效用。
PAD与mPAP有显著相关性（p<0.005，r=0.47）。此外，PA:AA比值和PA面积与AA面积比值与mPAP有显著相关性（分别为r=0.48和r=0.47；p<0.001）。使用ROC确定PAD的阈值为29mm。该指标的敏感性为0.55，特异性为70.2，曲线下面积为0.66。
尽管PAD和PA:AA比值有助于评估PH的存在，但我们得出结论，这些CT参数不足以在这组患者中确诊或排除PH。
