1、河北医科大学第二医院袁雅冬肺血管栓塞面积与肺动脉高压的相关研究This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the syst
2、em are AT89C51 microcontroller and DS18B20 temperature sensor.概况1 APTE发生后肺动脉压力呈不同程度升高3 UCG、 CTPA可用于全面评估肺动脉压力、心功能2 经尸检证实，肺动脉压力的升高程度 不仅与 栓塞面积大小有关 ，也会造成肺血管径线 及心功能 的相应改变This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measure
3、ment and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.l APTE发生后大约有 80%患者存在 PAH， mPAP增高并不明显，一般不超过 35mmHg-40mmHgl mPAP持续 30mmHg时提示预后较差， 5年存活率只有 30%l mPAP持续 50mm
4、Hg时 5年生存率仅为 14%发生 PAH的 APTE患者预后差mPAP（mmHg）5年生存率30%14%30 500This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The
5、 core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.pAPTE发生后 ， PASP常常于栓塞发生后 30分钟内急剧增高，于 1-2小时达峰p早期 便 出现 栓子 溶解 ， 这与血栓局部机械性变化及内源性血栓溶解有关p大部分 栓子 大约在 28天左右可以完全溶解 ，肺 动脉压力多于 38-42天左右而恢复至稳定状态APTE后肺动脉压力变化Grosse C， et al.Radiographics. 2010. 30(7): 1753-1777This paper mai
6、nly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 te
7、mperature sensor.n APTE患者其肺动脉压力能否恢复到正常与治疗是否及时、心肺储备、栓塞范围、血栓形成时间、血流动力学改变、患者自身纤溶系统活性等因素有关n 达到稳定状态下的肺动脉压力大小与 APTE发生后的初始肺动脉压力大小及患者的年龄有关，当初始肺动脉压力50mmHg，年龄 65岁的患者即使达到稳定状态其肺动脉压力也较高80%60%40%-50%25%-30%40mmHg猝死风险大死亡风险大肺动脉压力开始升高肺动脉压力正常尸检结果This paper mainly introduces the design of an intelligent temperature co
8、ntrol system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.死亡率 1.9%死亡率 83%Wu AS, et al. Radiology. 2
9、004. 230(3): 831-835.大部分 APTE患者栓塞面积 60%者 1年内死亡率为 83%栓塞面积大者短期内死亡率高This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcompute
10、r. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.栓塞面积与 PASP之间正相关肺动脉压力随着栓塞面积的增加而升高栓塞面积超过33% 时 PASP大于41mmHg，当栓塞面积超过 40% 时PASP大于70mmHg研究结果This paper mainly introduces the design of an intelligent temperature control system which realizes the function of te
11、mperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.栓塞面积p 当前有关栓塞面积的研究结果均来源于尸检结果p Qanadli等学者发现， APTE患者的肺血管阻塞程度可以通过 CTPA得以量化，量化结果可视为栓塞面积（ %）p
12、 用于评估栓塞程度的评分方法 包括 Mastora评分、 Miller评分、 Qanadli评分、 Walsh评分等 ，其中 Qanadli评分 因计算简单、重复操作性强、与肺动脉造影相关性强的优点 应用最为广泛Qanadli SD, et al. AJR Am J Roentgenol. 2001. 176(6): 1415-1420This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature mea
13、surement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 对中央型肺栓塞（肺动脉主干及肺叶动脉栓塞）、周围型栓塞肺栓塞（节段肺动脉及亚段肺动脉栓塞）及混合型肺栓塞（包括中央型及周围型）的肺血管阻塞情况 对 5条肺动脉主干 (0-25%)、 6条肺叶动脉 (
14、0-30%)、 20条亚段肺动脉 (0-100%)的阻塞程度进行 5个等级的评分 阻塞 0-25%计 1分 ，阻塞 25-49%计 2分 ，阻塞 50-74%计 3分，阻塞 75-99%计 4分 ，阻塞 100%计 5分 最后对不同部位的阻塞分数进行整合，整合结果即为Mastora评分结果，分数越高阻塞程度越严重Mastora评分Mastora I, et al. Eur Radiol. 2003. 13(1):29-35计算方法较繁琐This paper mainly introduces the design of an intelligent temperature control sy
15、stem which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.Miller 评分肺动脉造影结果节段肺血管存在栓子计 1分。右肺动脉满分为 9分，左肺动脉满分为
16、7分左、右肺分别划位 3部分（上、舌、下 /上、中、下），各部分无阻塞计 0分，中度阻塞计 1分，严重阻塞计 2分，完全阻塞计 3分。左、右肺满分均为为 9分将以上两部分分值相加，结果即为Miller指数，最高分为 34分G.AH Miller, et al. British Medical Journal. 1973. 2.681-684计算方法较繁琐This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temper
17、ature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.p 肺动脉造影结果p 计算机后处理Walsh评分Walsh PN, et al. Circulation. 1973. 47.101-107有创操作下评估This paper mai
18、nly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 te
19、mperature sensor. CTPA下直接测量节段肺动脉及亚段肺动脉的阻塞程度，并根据Qanadli评分方法计算栓塞面积。 具体方法为：测量左右各 10条节段肺 动脉 及 20条亚段 肺动脉 (n)的栓塞程度 (d)， 每条节段肺动脉不存在栓子计 0分、存在栓子但未完全阻塞管腔计 1分、完全阻塞管腔计 2分，其中若亚段肺 动脉 管腔阻塞，视为其所在节段肺 动脉 不完全阻塞， 计 1分，每条节段肺 动脉 总分不超过 2分；若节段 动脉 以上出现栓子，则视为分支 动脉 完全阻塞，计满分。 将测量的结果逐一相加，每个区域的最高分为 20分，总分 为 40分，其公式为 (nd)/40100，得
20、出的数值为栓塞面积Qanadli评分Qanadli SD, et al. AJR Am J Roentgenol. 2001. 176(6): 1415-1420方法简便，可重复性操作This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 a
21、nd single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. 204例确诊的急性肺栓塞（ APTE）患者 男性占 44.9%(92例 )，女性占 54.6%(112例 ) 平均年龄为 59.7513.49岁 (24 88岁 )，年龄 65岁者占 74.02%(151例 ) 用 Qanadli评分方法计算栓塞面积 UCG检查评估肺动脉收缩压（ PASP） 肺动脉压力正常组 (PASP70mmHg) This pa
22、per mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS1
23、8B20 temperature sensor.l 栓塞面积与 PASP呈正相关， PASP随着栓塞面积的增加呈逐渐上升的趋势l 栓塞面积 33%时提示中度 PAH，栓塞面积 40%提示重度PAH栓塞面积（ %）肺动脉压力正常组 17.713.6轻度 PAH36-40mmHg18.313.8中度 PAH40-70mmHg33.410.9重度 PAH70mmHg40.615.7R 0.514P 0.000与尸检结果基本一致栓塞面积与栓塞面积与 PASP的关系的关系This paper mainly introduces the design of an intelligent temperatu
24、re control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.计算的栓塞面积（ %）尸检结果肺动脉压力正常组 17.713.6 70m
25、mHg40.615.7 40 50%肺动脉压力 40mmHgThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the syste
26、m are AT89C51 microcontroller and DS18B20 temperature sensor.肺动脉压力评估方法 -CTPA健康成人 PAH患者uPA21mmuPA/AA1uPA/AA1， 重度 PAH形成时其 PA径线往往超过35mmThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single
27、bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.The sensibility of CTPA in diagnosis with PAHCTPA诊断 PAH的敏感性Tan RT， et al.Chest.1998. 113(5):1250-1256Ng CS,et al.J ThoracImaging.1999.14(
28、4):270-278This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microc
29、ontroller and DS18B20 temperature sensor. DAlonzo GE认为： 正常人的主肺动脉径线 (PA)21mm 主肺动脉径线 /主动脉径线 (PA/AA)1:1或者 PA/AA1:1 当 PA35mm则提示恶性 PAH。 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single b
30、us digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.栓塞面积（ %）PA/AA肺动脉压力正常组17.713.6 0.910.17轻度 PAH 18.313.8 0.970.16中度 PAH 33.410.9 1.060.18重度 PAH 40.615.7 0.170.11R 0.514 0.469P 0.000 0.000R=
31、0.226P33%时提示中度 PAH栓塞面积 40%时提示重度 PAHThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the
32、system are AT89C51 microcontroller and DS18B20 temperature sensor.栓塞面积（ %）PA肺动脉压力正常组17.713.6 28.85.03轻度 PAH 18.313.8 30.84.01中度 PAH 33.410.9 32.56.67重度 PAH 40.615.7 35.55.76R 0.514 0.383P 0.000 0.000R=0.210P70mmHg40.615.7 1.630.34R 0.514 0.25P 0.000 0.000PA/椎体随着肺动脉压力升高其数值逐渐增加 ， 只有达到重度PAH阶段后增加显著 This
33、 paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and
34、DS18B20 temperature sensor.栓塞面积与栓塞面积与 RPA的关系的关系栓塞面积（ %）RPA肺动脉压力正常组17.713.6 20.144.48轻度 PAH 18.313.8 17.92.50中度 PAH 33.410.9 20.053.46重度 PAH 40.615.7 23.254.47R 0.514 0.25P 0.000 0.000R=0.173P0.05对于 RPA而言 ,只有达到重度 PAH阶段后明显增粗This paper mainly introduces the design of an intelligent temperature control
35、system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.PA/椎体 RPA PA PA/AA PASPR=0.153R=0.173R=0.21R=0.
36、226R=0.514与栓塞面积相关性的比较This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT8
37、9C51 microcontroller and DS18B20 temperature sensor.PA/椎体 RV/LV PA PA/AA 栓塞面积RPAR=0.186R=0.250R=0.330R=0.383R=0.469R=0.514与 PASP相关性的比较This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using singl
38、e bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor. Qanadli等曾在研究中发现此评分方法与肺动脉造影判断栓塞程度结果的相关性强，与 mPAP为弱相关。当前尚缺少大规模临床研究 由于 CTEPH的形成不仅仅与血管阻塞程度有关，还与缩血管物质释放、血管重建、反射性血管收缩及低氧血症相关，因而 Qanadli栓塞指数并不
39、适用于评估 CTEPH患者的血流动力学变化Qanadli评分方法的局限性马展鸿等 . 实用放射学杂志 . 2010. 26(9): 1254-1258McIntyre KM, Sasahara AA Am J Cardiol. 1971. 28(3): 288-294.研究对象： CTEPH患者This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control
40、by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.在临床应用中还需要除外引起肺动脉扩张的影响因素，比如高血容量、肺纤维化组织对邻近血管存在牵拉作用可导致肺血管被动扩张，以及年龄、体表面积等Sinem Karazincir,et al. Diagn Interv Radio 2008.14:7
41、2-74.BAS影响 PAThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 mic
42、rocontroller and DS18B20 temperature sensor.p 节段肺动脉 直径， R=0.24p PA/椎体直径 ， R=0.23p 节段肺动脉直径 /伴随支气管直径 ， R=0.19p RPA， R=-0.79Devaraj A, et al. Radiology. 2010. 254(2): 609-616.目前 以下 指标诊断 PAH尚无界定 ，但均可体现肺动脉压力变化DAlonzo et al Ann Intern Med. 1991. 115(5): 343-349.Haimovici JB, et al. Acad Radiol. 1997. 4(5)
43、: 327-334.与 mPAP相关性分析结果This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.UCG pk CTPA在 CTD相关性 PAH中发现CTPA、 CTRV与 mPAP弱相关CTPA/AA、 CTRV/LV与 mPAP强相关，后者相关性更强UCG与 mPAP相关性强于CTPAmPAPRHC=0.27TGECHO+29.355PA/AA-9.031mPAPRHC=38.968PA/AA+8.589RV/LV-16.075Robin Condliffe,et al. Rheumatology 2011;50:1480-1486.
