氨基末端脑钠肽前体水平与急性肺栓塞致右室功能不全的相关性分析

NT-proBNP level with acute pulmonary embolism of right ventricular dysfunction caused by correlation study

目的探讨急性肺栓塞(APE)患者血浆氨基末端脑钠肽前体(NT-proBNP)浓度与右心衰竭的相关性,以及了解对APE预后评估的临床意义。方法选取2014年1月至2017年1月心内科住院的62例APE患者作为研究对象,分为右室功能不全组35例和右室功能正常组27例,2组又分为存活和死亡亚组,其中右室功能不全组存活27例,死亡8例,右室功能正常组存活27例,死亡0例,监测患者入院第一次和最后一次的NT-proBNP浓度,对比各组间的差异。结果右室功能不全组患者NT-proBNP浓度较右室功能正常组明显升高,该组死亡亚组患者NT-proBNP浓度较存活亚组明显升高,差异具有统计学意义(P<0.05),且治疗前后NTproBNP水平下降不明显,P>0.05,而存活亚组治疗前后NT-proBNP浓度下降明显,P<0.05,同样差异具有统计学意义;所有死亡亚组NT-proBNP水平较存活组明显增高。结论急性肺栓塞患者血浆NT-proBNP浓度与右室功能具有明显的相关性,可作为疗效判断及预后评估参考。

Objective To investigate the correlation between the concentration of plasma NT-proBNP and acute right heart failure in patients with acute pulmonary embolism（APE）and to evaluate the clinical significance of assessing the prognosis of APE.Methods Sixty-two patients with APE who were hospitalized in department of cardiology from January 2014 to January 2017 were selected and divided into 35 cases with right ventricular dysfunction and 27 cases with normal right ventricular function.The two groups were divided into survival and death subgroup,including 27 patients with right ventricular dysfunction group,8 patients died,27 patients with normal right ventricular function and 0 patients died.The first and last NT-proBNP concentrations were monitored and the differences between groups were comared.Results NT-proBNP concentrations in patients with right ventricular dysfunction were significantly higher than those in patients with normal right ventricular function.NT-proBNP concentrations in the death subgroup were significantly higher than those in survival subgroups（P〈0.05）,and the difference was statistically significant.The level of NT-proBNP did not decrease significantly before and after treatment（P〈0.05）,while the level of NT-proBNP decreased significantly in survival subgroup before and after treatment（P〈0.05）,and the difference was statistically significant in the same way.NT-proBNP levels in all death subgroups were significantly higher than those in survival subgroups.Conclusion The plasma NT-proBNP concentration in patients with acute pulmonary embolism has a significant correlation with right ventricular function,which can be used as a reference for judgment of curative effect and evaluation of prognosis.