N-末端脑钠肽前体联合超声心动图对急性肺栓塞患者预后的评估

Value of NT-proBNP combined with echocardiogram in the evaluation of prognosis in patients with acute pulmonary embolism

目的明确N-末端脑钠肽前体(NT-proBNP)联合超声心动图在急性肺栓塞(APE)患者预后评估中的价值。方法收集2005年1月至2011年5月收治的48例急性肺栓塞患者的临床资料,分别分为死亡组与存活组,高NT-proBNP组与低NT-proBNP组,高肺动脉收缩压(PASP)组与低PASP组;分别比较两组间一般指标、肾功能、NT-proBNP值、PASP值、大面积APE发生率以及死亡率的差异。结果各组间性别、年龄以及肾功能指标均无统计学差异(P>0.05);死亡组大面积APE发生率、PASP及NT-proBNP均明显高于存活组,且差异有统计学意义(P<0.05);高NT-proBNP组大面积APE发生率及死亡率均明显高于低NT-proBNP组(P<0.05);高PASP组大面积APE发生率及死亡率均明显高于低PASP组(P<0.05);相关分析显示PASP与NT-proBNP两者呈显著正相关(r=0.423,P<0.01)。结论 NT-proBNP联合超声心动图对APE患者预后的评估有较大价值。

Objective To determine the value of N-terminal pro-B-type natriuretic peptide(NT-proBNP) combined with echocardiogram in the evaluation of prognosis in patients with acute pulmonary embolism(APE).Methods Clinical data of 48 patients with APE in our hospital from January 2005 to May 2011 were collected and divided into death group and survival group,high NT-proBNP group and low NT-proBNP group,high PASP group and low PASP group.General indexes,renal function,NT-proBNP,PASP,28-day mortality and the rate of massive APE between every two groups were compared respectively.Results There were no significant differences among all groups on the following items such as age,sex and renal function(P>0.05).However,PASP,NT-proBNP and the rate of massive APE in the death group were higher as compared with that in the survival group(P<0.05).The mortality and the rate of massive APE in the high NT-proBNP group were higher as compared with that in the low NT-proBNP group(P<0.05).The mortality and the rate of massive APE in the high PASP group were higher as compared with that in the low PASP group(P<0.05).Correlation analysis showed that there was significant positive correlation between PASP and NT-proBNP(r=0.423,P<0.01).Conclusions NT-proBNP combined with echocardiogram may have greater value in the evaluation of prognosis in patients with APE.