高敏肌钙蛋白和心型脂肪酸结合蛋白对急性肺栓塞患者预后的影响

The Influences of High Sensitivity Cardiac Troponin and Heart Type Fatty Acid Binding Protein in Prognosis of Patients with Acute Pulmonary Embolism

目的:探索高敏肌钙蛋白(hs-c Tn T)和心型脂肪酸结合蛋白(H-FABP)在预测急性肺栓塞(APE)患者预后的作用。方法:选择2011年5月-2013年5月在笔者所在医院诊断APE患者62例。所有患者入院时检测hs-c Tn T、H-FABP、c Tn I、肌酐、NT-pro BNP、血常规等指标。随访时间为1年,记录临床不良事件发生(MACE)。多因素Logistic回归分析与全因死亡有关因素。结果:在院及随访1年期间内,H-FABP和hs-c Tn T阳性MACE率较高。APE全因死亡率Logistic回归分析,心源性休克、hs-c Tn T、H-FABP与患者死亡显著相关(P<0.01),其敏感性高于NT-pro BNP和c Tn I(P<0.05),而年龄、是否溶栓与全因死亡无关。结论:APE患者hs-c Tn T、H-FABP水平升高者发生MACE率高,远期预后差。

Objective：To explore the influences of high sensitivity cardiac troponin T（hs-c Tn T） and heart type fatty acid binding protein（H-FABP） in prognosis of patients with acute pulmonary embolism（APE）.Method：62 cases with APE were recruited in our hospital from May 2011 to May 2013.Hs-c Tn T,H-FABP,c Tn I,creatinine,NT-pro BNP and blood routine were tested at the time of hospitalization.Patients were followed-up for one year.Then the major adverse cardiac events（MACE） were recorded.Using Logistic regression analysis to assess the related factors for all-cause mortality.Result：During the hospitalization and follow-up,the incidences of MACE were higher in H-FABP and hs-c Tn T groups than that in other groups.Multivariate Logistic regression analysis showed that cardiac shock,hs-cTnT acuity,H-FABP acuity were associated with all-cause mortality（P〈0.01）.The sensitivity was higher than the NT-pro BNP and c Tn I.While age,thrombolysis or non-thrombolysis had nothing to do with patients dead（P〉0.05）.Conclusion：There are high incidences of MACE in patients with higher levels H-FABP and hs–c Tn T.Also the long-term prognosis is poor.