血浆D-二聚体、NT-proBNP联合检测在急性肺栓塞中的临床价值

Clinical significance of plasma D-diner and amino-terminal pro-brain natriuretic peptide in acute pulmonary embolism

目的探讨血浆D-二聚体、氨基末端脑钠肽前体(NT-pro BNP)对急性肺栓塞(APE)患者诊断、疾病严重程度及预后评估的价值。方法收集2015年1月至2017年12月郑州大学第一附属医院收治的经CTPA检查确诊的71例APE患者为观察组;同期随机选择的郑州大学第一附属医院的40例健康体检者为对照组,分别进行D-二聚体、NT-pro BNP水平检测;依据患者预后情况将观察组分为预后良好组、预后不良组,并进行相关数据对比分析。结果观察组血浆NT-pro BNP、D-二聚体水平高于对照组,差异有统计学意义(P<0.05)。观察组中预后不良组NT-pro BNP水平高于预后良好组,差异有统计学意义(P<0.05);预后不良组与预后良好组D-二聚体水平比较,差异无统计学意义(P>0.05)。结论 APE患者NT-pro BNP水平越高,患者的病情越重,预后越差。联合检测患者血浆NT-pro BNP及D-二聚体有助于临床医生早期诊断APE,对疾病预后判断具有一定临床意义。

Objective To explore the diagnosis assessment of disease severity and prognosis on plasma D-dimer and amino-terminal pro-brain natriuretic peptide（ NT-proBNP） in patients with acute pulmonary embolism（ APE）. Methods Atotal of 71 cases APE patients confirmed by CTPA examination from January of 2015 to December of 2017 in the First Affiliated Hospital of Zhengzhou University were selected as observation group,and 40 healthy persons in the same period were selected as control group. The D-dimers,NT-proBNP level were tested. The patients in observation group were divided into good outcome group and poor outcome group according to the patient＇s prognosis,and related data was compared and analyzed. Results Plasma NT-proBNP,D-diner level were higher in observation group than that in control group,and the difference was statistically significant（ P〈0. 05）. NT-proBNP level of poor outcome group in the observation group was higher than that of good outcome group,and the difference was statistically significant（ P〈0. 05）.The difference in D-dimer between poor outcome group and good outcome group was not statistically significant（ P〈0. 05）.Conclusion The higher the level of NT-proBNP in patients with APE,the more severe the disease and the worse the prognosis. The combined detection of patients＇ plasma NT-proBNP and D-dimer is helpful for the early diagnosis of APE by clinicians,and it has certain clinical significance for the prognosis judgment of disease.