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目的探讨放疗前彩超测量肺动脉血流加速时间(AT)在预测≥2级放射性肺损伤中的应用价值。方法自2013年6月—2015年1月,共纳入81例肺癌放疗患者,在放疗前对所有患者均行彩超检查,测量AT。根据放疗后随访结果,将病例分为发生≥2级放射性肺损伤组和未发生组,将二组放疗前测得的AT进行对比研究,通过ROC曲线探讨AT对于预测≥2级放射性肺损伤发生的准确性,并确定最佳cutoff值。结果 81例肺癌患者中有18例发生了≥2级放射性肺损伤。发生放射性肺损伤组的AT为(105.7±17.4)ms,未发生放射性肺损伤组的AT为(124.8±14.4)ms,二者差异有统计学意义(P<0.05)。ROC曲线下面积为0.821,确定最佳cutoff值为113ms,以AT<113ms为标准来预测≥2级放射性肺损伤的发生,其敏感性、特异性和准确性分别为81.6%、85.7%和82.5%。结论放疗前彩超测量肺动脉血流加速时间可以预测≥2级放射性肺损伤的发生,对临床有一定的指导作用。
Objective To investigate the value of pre-radiosensory color Doppler ultrasonography to measure the pulmonary artery blood flow acceleration time (AT) in predicting ≥2 grade radiation-induced lung injury. Methods From June 2013 to January 2015, a total of 81 patients with lung cancer were included in the study. Color Doppler ultrasound was performed on all patients before radiotherapy, and AT was measured. According to the results of follow-up after radiotherapy, the cases were divided into group of ≥2 radiosensitve lung injury and non-occurrence group. The AT measured before radiotherapy of the two groups were compared and studied. The ROC curve was used to investigate the effect of AT on the prediction of ≥2 radiographic lung injury The accuracy and determine the best cutoff value. Results Of the 81 patients with lung cancer, 18 patients had ≥2 grade radiation lung injury. The incidence of AT in radiation-induced lung injury group was (105.7 ± 17.4) ms and that in non-radiation-induced lung injury group was (124.8 ± 14.4) ms, the difference was statistically significant (P <0.05). The area under the ROC curve was 0.821, the best cutoff value was 113 ms, and the sensitivity, specificity and accuracy were 81.6%, 85.7% and 82.5 %. Conclusion Pre-radiosensitivity color-ultrasonography measurement of pulmonary artery blood flow acceleration time can predict ≥2 level of radiation-induced lung injury, the clinical guidance.