目的 探讨CT肺动脉成像对慢性 阻塞性肺疾病(COPD)合并肺动脉高压的诊 断价值。方法 选择医院2016年4月-2018 年4月收治的COPD合并肺动脉高压患者80 例，所有患者均进行CT肺动脉成像，根据 超声心动图测量的肺动脉收缩压分为轻中 度组(53例)和重度组(27例)，分别测量 主肺动脉直径(MPAD)、右肺主动脉直径 (RPAD)及左肺主动脉直径(LPAD)，并采 用ROC曲线分析MPAD、RPAD及LPAD在评估 COPD合并肺动脉高压中的价值，同时观察 肺部渗出性病变及胸腔积液情况。结果 重度组的MPAD、RPAD及LPAD均大于轻中度 组(P＜0.05)。重度组的肺部渗出性病变 及胸腔积液的发生率均高于轻中度组(P ＜0.05)。ROC曲线分析显示，MPAD评估重 度肺动脉高压的敏感性高于轻中度肺动脉 高压(P＜0.05)。结论 通过CT肺动脉成像 测量MPAD、RPAD及LPAD值，观察肺部渗出 性病变及胸腔积液情况，可及早发现COPD 合并肺动脉高压，且对肺动脉高压分级有 一定帮助，具有重要的诊断价值。

Objective To explore the diagnostic value of CT pulmonary artery imaging for chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension. Methods 80 cases of patients with COPD and pulmonary hypertension who were admitted to the hospital from April 2016 to April 2018 were selected and given CT pulmonary artery imaging. According to the pulmonary systolic pressure measured by ultrasonic cardiogram, the patients were divided into mild-to-moderate group (53 cases) and severe group (27 cases). The main pulmonary artery diameter (MPAD), right pulmonary aortic diameter (RPAD) and left pulmonary aortic diameter (LPAD) were measured, and the ROC curve was used to analyze the values of MPAD, RPAD and LPAD in assessing COPD with pulmonary hypertension. And the pulmonary exudative lesions and pleural effusion were observed. Results The MPAD, RPAD and LPAD in severe group were greater than those in mild-to-moderate group (P<0.05). The incidence rates of pulmonary exudative lesions and pleural effusion in severe group were higher than those in mild-to-moderate group (P<0.05). ROC curve analysis showed that the sensitivity of MPAD for severe pulmonary hypertension was higher than that for mild-to-moderate pulmonary hypertension (P<0.05). Conclusion Measurement of MPAD, RPAD and LPAD by CT pulmonary artery imaging can observe the pulmonary exudative lesions and pleural effusion, and can have early detection of COPD with pulmonary hypertension, and it has a certain help for pulmonary hypertension classification, and it has important diagnostic value.