联合检测血清NT-proBNP、D-二聚体及超声心动图对肺动脉高压诊断的意义

Diagnostic value of the combined detection of serum NT-proB NP,D-dimmer and echocardiography parameters in pulmonary hypertention

目的通过观察肺动脉高压(Pulmonary hypertension,PH)患者血清标志物氨基末端脑钠肽前体(amino-terminal pro-brain natriuretic peptide,NT-Pro BNP)、D-二聚体(D-dimmer)及超声心动图参数的变化,为PH的诊断及病情评估提供依据。方法选取2015年1月至2016年6月期间在本院住院治疗的PH患者49例作为观察组,同期本院体检中心39例健康者为对照组。按照患者肺动脉收缩压(Pulmonary arterial systolic pressure,PASP)的高低程度将观察组分为轻、中、重三组。记录所有患者的NT-pro BNP、D-二聚体浓度及超声心动图参数变化,并对结果进行分析。结果观察组患者血清NT-Pro BNP(2954.88±2698.68 ng/L)及D-二聚体(1.98±1.95ug/L)水平高于对照组(分别为327.64±275.63ng/L、0.66±1.40 ug/L),差异有统计学意义(t值分别为6.77、3.68;P值均<0.05),且PASP与NT-pro BNP、D-二聚体呈正相关(r分别为0.434、0.478;P值均<0.01)。观察组主肺动脉显著增宽,右心房、右心室增大,与对照组比较差异有统计学意义(P<0.05);LVEF在观察组与对照组之间差别无统计学意义(P>0.05)。结论 PH患者的NT-pro BNP、D-二聚体水平、超声心动图参数明显增高,在重度PH的情况下尤为明显,对诊断及判断PH病情严重程度具有一定的临床价值,值得在临床应用中进一步推广。

Objective To investigate the correlation between the level of serum N-terminal pro-brain natriuretic peptide（ NT-pro BNP）,D-dimmer and echocardiography parameters and pulmonary hypertention. Methods The clinical data of 49 patients with pulmonary hypertention and 39 healthy subjects from January 2015 to June 2016 were selected. The treatment group were divided into three groups according to their pulmonary arterial systolic pressure（ PASP） ： the mild pulmonary hypertention group,and the moderate and severe pulmonary hypertention group.The level of NT-pro BNP,D-dimmer and echocardiography parameters were measured. Results The levels of serum NT-pro BNP and D-dimmer were higher in the treatment group NT-pro BNP：（ 2954. 88 ± 2698. 68） ng/L; D-dimmer：（ 1. 98 ± 1. 95） ug/L than those in the control group NT-pro BNP：（ 327. 64 ± 275. 63） ng/L; D-dimmer（ 0. 66 ± 1. 40） ug/L（ t = 6. 77,3. 68; P〈0. 05）. The levels of NT-pro BNP and D-dimmer were significantly positive correlated with PASP（ r = 0. 434,0. 478; P〈0. 01）. The level of main pulmonary width（ MPAD）,right atrium transverse diameter（ RAD） and right ventricle anteroposterior diameter（ RVD） was higher in the treatment group than that in the control group（ P〈0. 05）,but there was no significance in left ventricular ejection fraction（ LVEF）between the two groups. Conclusion The serum NT-pro BNP,D-dimmer and echocardiography parameters increase gradually with the elevating of pulmonary hypertention,especially in severe PH,which can be used as indicators to diagnose and evaluate the degree of PH.