联合检测肌钙蛋白、氨基末端脑钠肽前体在急性肺栓塞中的临床意义

Clinical Significance of Plasma Troponin Ⅰ and Amino-terminal-Brain Natriuretic Peptide Precursor in Acute Pulmonary Embolism

目的:探讨急性肺栓塞(APE)患者肌钙蛋白I(cTnⅠ)和氨基末端脑钠肽前体(NT-proBNP)浓度变化以及在诊断、判断预后方面的意义。方法:收集临沂市中心医院2014年6月-2015年12月期间收治的急性肺栓塞患者42例为实验组,所有患者均行肺动脉CT血管成像检查(肺动脉CTA)确诊肺栓塞,根据患者预后分为预后良好组、预后不良组,同一时期随机选取我院40例健康体检者为对照组。分别进行cTnⅠ、NT-proBNP浓度检测;对实验组与对照组、预后良好组与预后不良组的cTnⅠ、NT-proBNP数据进行对比分析。结果:实验组cTnⅠ为(1.2±0.56)ng/ml,NTproBNP为(1 223±445)pg/ml,对照组cTnⅠ为(0.1±0.13)ng/ml,NT-proBNP为(40±17.4)pg/ml,两组比较差异有统计学意义(P<0.05);肺栓塞患者中预后不良组cTnⅠ为(3.3±1.56)ng/ml,NT-proBNP为(4 483±960)pg/ml,预后良好组cTnⅠ为(0.7±0.37)ng/ml,NT-proBNP为(562±118)pg/ml,两组比较差异有统计学意义(P<0.05)。实验组cTnⅠ、NT-proBNP浓度明显高于对照组,实验组中预后不良组cTnⅠ、NT-proBNP浓度较预后良好组高。结论:联合检测血浆cTnⅠ、NT-proBNP对急性肺栓塞患者诊断、预后判断具有较好的临床意义。

Objective：To explore the concentration change, the diagnostic and prognostic clinical meaning of cardiac troponin I（cTnI）and amino-terminal-brain natriuretic peptide precursor（NT proBNP）in acute pulmonary embolism （APE） patients. Methods：42 APE patients from June 2014 to December 2015 of central hospital of Linyi city were selected as experimental group, all patients were diagnosed by computer tomography pulmonary angiography（CTPA）. According to the clinical outcome,APE patients were divided into good outcome group and bad outcome group,and 40 healthy people for physical examination in our hospital at the same period were selected as control group. The concen- tration of cTnI and NT-proBNP in experimental group and control group, in good outcome group and bad outcome group, was compared respectively. Results： APE group： cTnI of is （ 1.2±0.56 ） ng/ml, NT-proBNP is （ 1 223±445 ） pg/ mhcontrol group：eTnI is（0.1±0.13）ng/mh NT-proBNP is（40±17.4）pg/ml, the difference was statistically significant（P〈0. 05）. In the APE patients, bad outcome group： cTnI is（3. 3±1.56） ng/ml, NT-proBNP is（4 483±960） pg/ ml, good outcome group： cTnI is （ 0. 7±0. 37 ） ng/ml, NT-proBNP is （ 562±118 ） pg/ml, the difference was statistically significant（P〈0. 05）. The concentration of cTnI and NT-proBNP in experimental group was significantly higher than that of control group, and the concentration of cInI and NT-proBNP in bad outcome group was higher than that of good outcome group, the difference was statistically significant （P〈0. 05）. Conclusion： Detecting the concentration of cTnI and NT-proBNP has clinical meaning for diagnositic and prognostic assessment of acute pulmonary embolism patients.