BNP在急性肺栓塞中的变化及意义

Plasma BNP Level Change and Clinical Value in Acute Pulmonary Embolism

目的探讨BNP水平在急性肺栓塞(APE)的变化及其意义。方法33例经肺螺旋CT+肺动脉造影或数字减影肺动脉造影确诊为APE患者,分为右室功能不全组和无右室功能不全组,采用干式快速定量心衰诊断仪测定血脑钠肽(BNP)后比较两组差异和观察比较两组患者临床表现、病死率、需要机械通气支持差异。结果右心室功能不全组BNP水平(288±102pg/ml)明显高于无右心室功能不全组(61±32pg/ml)(P<0.05);前者严重临床表现晕厥、低血压或休克高于后者(P<0.05);前者表示右室功能指标:肺主动脉内径和压力、右室内径、右室活动度与后者比较也有显著差异(P均<0.05);前者病死率、需要机械通气率高于后者。结论BNP水平对判断APE时右心室功能有一定价值,从而可以帮助APE患者危险分层及预后判断。

Objective To evaluate plasma BNP level change in acute pulmonary embolism and its clinical value. Methods 33 cases were diagnosed by CT pulmonary angiography or DSA. they were divided into two groups： the group with right ventricular（RV） dysfunction group and the group without right ventricular（ RV ） dysfunction. Plasma BNP was detected by Triage BNP test. otherwise, we observed severe clinical presentation, death rate and mechanical ventilation in two groups. Results Plasma BNP level is higher in the group with RV dysfunction（288 ± 102pg/ml）than that in the group without RV dysfunction （61 ± 32pg/ml）（P 〈 0.05 ）. Syncope and hypotension are more frequent in the RV dysfunction group than that in the group without RV dysfunction. Death rate and mechanical ventilation rate are higher in the RV dysfunction group than that in the group without RV dysfunction. Conclusions Plasma BNP level can help us to distinguish RV dysfunction in APE and assess risk stratification.