脑钠肽和D-二聚体检测对急性肺栓塞早期诊断及预后评估的价值

The value of B-type natriuretic peptide and D-dimer detection in the early diagnosis and prognosis of acute pulmonary embolism

目的应用脑钠肽和D-二聚体的检测方法,以期达到对急性肺栓塞的早期诊断及预后判断。方法26例急性肺栓塞患者分为两组:观察组12例,给予脑钠肽、D-二聚体检查,确诊为肺栓塞后给予溶栓、抗凝治疗。对照组14例,给予心电图、胸片、心超、血气分析检查及外院肺通气灌注扫描检查,确诊为肺栓塞后给予溶栓、抗凝治疗;比较两组患者的确诊时间、病死率。结果观察组的确诊时间(14.1±1.8h)和病死率(25.0%)显著低于对照组(23.3±1.5h、35.7%),差异均具有显著性(P<0.05)。结论联合应用脑钠肽和D-二聚体的检测方法对急性肺栓塞患者能够有效的缩短确诊时间、改善临床症状、降低死亡率。

Objective To explore the application of B - type natriuretic peptide and D - dimer detection in the early diagnosis and prognosis of acute pulmonary embolism. Methods Twenty - six cases of acute pulmonary embolism were divided into observation group （ 12 cases） and control group （14 cases）. B -type natriuretic peptide and D -dimer were examined for the patients in observation group, while the patients in control group were examined with electrocardiogram, chest radiograph, heart ultrasound, blood gas analysis and lung ventilation perfusion scan. Patients in both groups were treated with thrombalytic therapy and antieoagulation therapy after diagnosis. The time spent for final diagnosis and mortality rate on the day 14 of treatment in the two groups were analyzed and compared. Results The time spent for final diagnosis and mortality rate in the observation group（ 14 ± 1.8 h and 25.0% ） were significantly lower than those in the control group（23 ± 1.5 h,35.7% ） （ P 〈0.05 ）. Conculsion The combined application of B - type natriuretie peptide and D - dimer examination for patients with acute pulmonary embolism can effectively reduce the diagnosis time and reduce mortality.