探讨脑钠肽水平与中央型肺栓塞的关系

To Explore the Relationship between Serum Brain Natriuretic Peptide and Central Pulmonary Embolism

为了探讨脑钠肽(BNP)与中央型肺栓塞(CPE)的关系,将74例经CT肺动脉造影确诊的急性肺栓塞患者根据栓塞血管的等级分为CPE组39例和PPE(周围型肺栓塞)组35例。对两组的临床、辅助检查、治疗方法等20余变量行单因素及Logistic回归多因素分析。单因素分析显示CPE组心率快于PPE组,BNP>100pg/ml者比率大于PPE组,PaO_2、PaCO_2均低于PPE组,P_((A-a))O_2高于PPE组,S_1Q_3T_3、T_(v1-v4)倒置、右室扩大比率大于PPE组。Logistic回归多因素分析显示仅BNP>100pg/ml与CPE发生相关。因此,CPE组患者心肺功能差于PPE组,病情重于PPE组;CPE发生时BNP升高。

To explore the relationship between serum brain natriuretic peptide（ BNP） and central pulmonary embolism（ CPE）,a retrospective study was employed. All 74 acute pulmonary embolism patients who were hospitalized were diagnosed by means of pulmonary CTA. CPE was diagnosed when thrombotic material was seen in the main trunk or right or left main branches of the pulmonary artery,and peripheral pulmonary embolism（ PPE） was diagnosed when thrombotic material was seen exclusively in segmental or subsegmental arteries. 39 CPE and 35 PPE patients were enrolled into this study. More than twenty clinical、laboratory and physical examination variables were used as the research factors and CPE as the related factor. The data was analyzed with univariate analysis and Logistic regression model. Variables in the univariate analysis which were significantly associated with CPE were heart rate,BNP（ 100pg/ml）,PaO2,PaCO2,P（（ A-a））O2,S1Q3T3,T（v1-v4） wave inversion,enlarged right ventricle. In the Logistic regression model,variables which were significantly associated with CPE was only BNP（〉100pg/ml）.Therefore,the cardiopulmonary function of CPE is inferior to PPE and CPE is more severe than PPE. CPE associates an increased serum BNP level.