Matthay R A, Schwarz M I, Ellis J H, Steele P P, Siebert P E, Durrance J R, Levin D C
Invest Radiol. 1981 Mar-Apr;16(2):95-100. doi: 10.1097/00004424-198103000-00003.
Pulmonary artery hypertension is a frequent complication of severe chronic obstructive pulmonary disease (COPD). A study was undertaken to determine whether analysis of the chest radiograph can reveal the presence of pulmonary artery hypertension in COPD. Sixty-one men with COPD (forced expiratory volume in 1 second 0.97 +/- 0.35 liters, mean +/- SD) underwent right heart catheterization, and in 46 the mean pulmonary artery pressure was elevated (greater than 20 mmHg). Plain chest radiographs of the 61 patients and 42 normal control subjects were evaluated. The right descending pulmonary artery (RDPA) was enlarged (greater than 16 mm) in 43 of 46 patients (93%) with an elevated mean pulmonary artery pressure, and the left descending pulmonary artery (LDPA) diameter also was enlarged (greater than 18 mm) in 43 of 46. Combined increased RDPA and increased LDPA diameter measurements permitted correct diagnosis in 45 of 46 patients (98%) with pulmonary artery hypertension, including all 26 a mild elevation of mean pulmonary artery pressure (21-30 mmHg). There was a significant correlation between pulmonary artery pressure and both RDPA and LDPA measurements. Analysis of RDPA and LDPA diameters on the plain chest radiograph is a sensitive and accurate method of detecting the presence and severity of pulmonary artery hypertension in COPD.
肺动脉高压是重度慢性阻塞性肺疾病（COPD）的常见并发症。一项研究旨在确定胸部X线片分析能否揭示COPD患者中肺动脉高压的存在。61名患有COPD的男性（一秒用力呼气容积为0.97±0.35升，均值±标准差）接受了右心导管检查，其中46人平均肺动脉压升高（大于20 mmHg）。对这61例患者和42名正常对照者的胸部X线平片进行了评估。46例平均肺动脉压升高的患者中，有43例（93%）右下肺动脉（RDPA）增宽（大于16 mm），46例中有43例左肺动脉（LDPA）直径也增宽（大于18 mm）。RDPA增宽和LDPA直径增加的联合测量能够正确诊断46例肺动脉高压患者中的45例（98%），包括平均肺动脉压轻度升高（21 - 30 mmHg）的所有26例患者。肺动脉压与RDPA及LDPA测量值之间存在显著相关性。胸部X线平片上RDPA和LDPA直径的分析是检测COPD患者肺动脉高压的存在及严重程度的一种敏感且准确的方法。
