血浆脑钠肽、C-反应蛋白水平联合血气分析检测对肺栓塞患者临床分型的应用价值

The Clinical Value of Plasma Brain Natriuretic Peptide, C-Reactive Protein Level and Blood Gas Analysis in the Clinical Classification of Pulmonary Embolism

目的:研究血浆脑钠肽(BNP)、C-反应蛋白(CRP)水平联合血气分析检测对肺栓塞患者临床分型的应用价值,为临床分型和治疗提供理论基础。方法:选择我院2015年1月至2016年12月确诊为肺栓塞的112例住院患者,根据临床表现分为高危肺栓塞组(49例)和中低危肺栓塞组(63例),比较两组间的血浆BNP、CRP和血气分析结果,分析BNP、CRP、动脉二氧化碳分压(PaCO_2)、动脉氧分压(PaO_2)对高危肺栓塞诊断的灵敏度和特异度。结果:高危肺栓塞组合并右心功能不全、病死率均明显高于中低危肺栓塞组,差异有统计学意义(P<0.05)。高危肺栓塞组血浆BNP、CRP及PaCO_2均显著高于中低危肺栓塞组(P<0.05);高危肺栓塞组患者的PaO_2显著低于中低危肺栓塞组患者(P<0.05)。高危肺栓塞组血浆BNP、PaCO_2、PaO_2阳性率均显著高于中低危肺栓塞组(P<0.05),两组CRP阳性率比较无统计学差异(P>0.05)。血浆BNP、CRP和血气分析联合检验诊断高危肺栓塞灵敏度为97.96%,特异度为77.78%。结论:肺栓塞时血浆BNP、CRP、血气分析出现异常,三者联合检验对肺栓塞诊断和临床分型有一定价值,对最佳治疗方案的制定和预后判断具有重要的临床意义。

Objective： To investigate the clinical value of plasma brain natriuretic peptide （BNP）, C-reactive protein （CRP） and blood gas analysis in the clinical classification of pulmonary embolism, and to provide the theoretical basis for clinical classification and treatment. Methods： 112 inpatients diagnosed as pulmonary embolism from january 2015 to december 2016 were selected, who were divided into high risk pulmonary embolism group （49 cases） and middle and low risk pulmonary embolism group （63 cases） according to clinical manifestation, the results of plasma BNP, CRP and blood gas analysis between the two groups were compared, the sensitivity and specificity ofBNP, CRP, arterial partial pressure of carbon dioxide （PaCO2） and arterial oxygen partial pressure （PaO2） in the diagnosis of high-risk pulmonary embolism were analyzed. Results： The combination of high risk pulmonary embolism, right ventricular dysfunction and fatality rate were significantly higher than those in middle and low risk pulmonary embolism group, the difference was statistically significant （P〈0.05）. The levels of plasma BNP, CRP and PaCO： in the high risk pulmonary embolism group were significantly higher than those in the middle and low risk pulmonary embolism group （P〈0.05）; and the PaO2 in the high risk pulmonary embolism group was significantly lower than that in the middle and low risk pulmonary embolism group （P〈0.05）. The positive rates of plasma BNP, PaCO2 and PaO2 in high risk pulmonary embolism group were significantly higher than those in middle and low risk pulmonary embolism group （P〈0.05）, and there was no significant difference in CRP positive rate between the two groups （P〉0.05）. The sensitivity of BNP, CRP and blood gas analysis in diagnosis of high risk pulmonary embolism was 97.96% and specificity was 77.78%. Conclusion： Pulmonary embolism of plasma BNP, CRP, blood gas analysis is abnormal, the combination of the three test is valuable in the diagnosis and clinical classification of pulmonary embolism, which have a important clinical significance for the formulation and prognosis of the optimal treatment.