急性肺栓塞患者合并与不合并肺动脉高压时肌钙蛋白Ⅰ及氨基末端脑钠肽前体水平的差异

Study on the difference in serum levels of NT-proBNP and cTnⅠ in patients with acute pulmonary embolism complicated or not with pulmonary hypertension

目的探讨观察急性肺栓塞患者肌钙蛋白Ⅰ(cTnⅠ)及氨基末端脑钠肽前体(NT-proBNP)与肺动脉压力之间的关系。方法选择102例肺栓塞患者,通过超声心动图测得肺动脉收缩压值(PASP)将其分为肺动脉高压组(>30 mm Hg)54例,肺动脉压正常组(≤30 mm Hg)组48例。对所有入选的患者进行cTnⅠ、NT-proBNP和血气分析检测,观察cTnⅠ、NT-ProBNP在急性肺动脉栓塞患者中的临床意义及与肺动脉高压相关性。结果急性肺栓塞患者合并肺动脉高压组的cTnⅠ水平(0.0415±0.049 ng/ml)明显高于肺动脉压正常组(0.0255±0.0211 ng/ml),差异具有统计学意义(P<0.05);急性肺栓塞患者合并肺动脉高压组的NT-proBNP水平(2 696.3±1 933.38 pg/ml)明显高于肺动脉压正常组(465.7±226.48 pg/ml),差异具有统计学意义(P<0.05)。结论急性肺栓塞患者血清cTnⅠ和NT-proBNP的水平与是否合并肺动脉高压相关,cTnⅠ和NT-proBNP可作为急性肺动脉栓塞患者病情评估的可靠指标。

Objective To explore the relationship between serum levels of cTnl, NT - proBNP and pulmonary hypertension in patients with acute pulmonary embolism （ APE）. Methods A total of 102 patients with acute pulmonary embolism were enrolled in this study, and pulmo-nary artery systolic pressure （PASP） had been measured by echocardiography in all patients with APE. They were divided into two groups accord-ing to PASP 54 cases in pulmonary hypertension （APE - PH） group （ 〉30 mmHg） and 48 cases in normal group （〉30 mmHg）. After admis-sion ,blood samples were drawn in all these patients to measure serum levels of cTnl, NT - proBNP and blood gas analysis immediately in order to study the clinical significance of cTnl and NT - proBNP in patients with acute pulmonary embolism and their correlation with pulmonary hyperten-sion. Results Serum level of cTnl in APE - PH group （0. 0415 ± 0. 049 ng/ml） was higher than that of normal ones （0. 0255 ± 0. 0211 ng/ ml）,and the difference was statistically significant （ P 〈0？ 05 ）.Serum level of NT - proBNP in APE - PH group （2 696. 3 ± 1 933. 38 pg/ml） was higher than that of normal group （465. 7 ± 226. 48 pg/ml ）,and the difference was statistically significant （ P 〈0.05 ） .Conclusion The serum levels of cTnl and NT - proBNP in patients with acute pulmonary embolism are closely associated with pulmonary hypertension. These mark-ers can be used as reliable indicators for assessment of the situation of patients with acute pulmonary embolism.