Objective:To evaluate the clinical value of electron beam computed tomography(EBCT)in diagnosis and surgical treatment of chronic thromboembolic pulmonary hypertension.Methods:From December 2003 to May 2006,eight patients with chronic pulmonary thromboembolism accept EBCT examination before and after surgical pulmonary thromboendarterectomy(PTE).Clinical and features of EBCT imaging were analyzed.Results:Before operation,in 8 patients EBCT study showed 7 vessels of pulmonary artery trunk with mural filling defect,28 vessels of lobar and segmental artery with partial filling defect,6 vessels with total occlusion,2 patients with mosaic sign in lung window.After operation(1~2 weeks later),EBCT study showed total occlusion in 6 patients,mural filling defect of 7 vessels and partial filling defect of 22 vessels all disappeared.Conclusion:EBCT is an effective method in diagnosis and treatment of chronic thromboembolic pulmonary hypertension.It can play a significant role in treating and follow-up of PTE.
患者,女, 43岁,因阵发性腹痛 10年,加重伴发作性头晕 1周入院.患者 10年前因阵发性腹痛在当地医院诊断为胆囊炎,胆石症,未进一步诊治.近半年来腹痛发作频繁. 1周前患者无明显诱因再次发作腹痛,以剑突下为主,持续约 2 h不缓解,伴头晕、心悸、大汗,于当地医院就诊.当时血压 50～ 60 mmHg,心率减慢达 38次 /min,心电图为窦性心动过缓,给予对症支持治疗后缓解,疑为心脏病,转入我院.既往高血压病史 1年,最高 150/90 mmHg,平素口服倍他乐克 25 mg,1次 /d,血压控制尚可.入院时体检:血压 150/90 mmHg,心率 65次 /min,心肺及腹部体检未见明显异常.入院后查血生化示谷丙转氨酶 127 U/L,谷草转氨酶 154 U/L,余正常范围;心脏正侧位片未见异常;超声心动图大致正常,运动核素心肌灌注扫描未见异常.诊断为胆心综合征,慢性胆囊炎,胆囊结石.
Pulmonary hypertension is clinically defined as a mean pulmonary arterial pressure of more than 25 mm Hg at rest or 30 mm Hg during exercise.With the development of the aetiology,the treatments for cellular hyperplasia and vascular remodeling have improved greatly prognosis of pulmonary hypertension patients.This paper reviews the application of endothelin-receptor antagonist in pulmonary hypertension.
