血浆脑钠肽、肌钙蛋白Ⅰ联合D-二聚体检测对急性肺栓塞患者的临床意义

Clinical Significance of Brain Natriuretic Peptide (BNP),Cadiac TroponinⅠ(cTnⅠ),and D-dimer Detection in the Acute Pulmonary Embolism (APE)

目的:探讨检测急性肺栓塞(APE)患者血浆脑钠肽(BNP)、肌钙蛋白Ⅰ(c TnⅠ)与D-二聚体(D-dimer)水平的临床意义。方法:76例APE患者根据栓塞面积分为大面积APE组(n=36)与非大面积APE组(n=40),测定两组患者的BNP、c TnⅠ、D-二聚体水平,同时采用超声心动图检测右心功能,并统计病死率。结果:大面积APE组BNP、c TnⅠ值显著高于对非大面积APE组,两组比较差异均有统计学意义(P<0.05),两组D-二聚体比较差异无统计学意义(P>0.05)。大面积APE患者患右心功能不全发生率及病死率分别为69.4%与22.2%,均显著高于非大面积APE组的15.0%与2.5%,两组比较差异均有统计学意义(P<0.01)。结论:通过对APE患者血浆BNP、c TnⅠ水平的检测可对患者进行危险分层及预后评估,D-二聚体水平的检测可作为诊断APE的排除指标。

Objective：To discuss the clinical significance of BNP,cTnⅠ and D-dimer detection in patients with APE.Method：76 patients with APE were divided into the massive APE group of 36 cases and the non massive APE group of 40 cases according to the embolization area,then the levels of BNP,c TnⅠ and D-dimer,right heart function and mortality of two groups were contrasted.Result：The levels of BNP and c TnⅠ in the massive APE group were significantly higher than the non massive APE group,the differences were statistically significant（P0.05）,but no significantly on D-dimer（P0.05）.The incidence of right heart function failure and the fatality rate in the massive APE group was respectively 69.4% and 22.2%,significantly higher than 15.0% and 2.5% in the non massive PE group,the difference was statistically significant（P0.01）.Conclusion：Detection of plasma BNP and c Tn I levels can estimate the risk stratification and prognosis in patients with APE,the detection of D-dimer level can be used as an exclusion marker for excluding diagnosis of APE.