急性肺血栓栓塞血浆肌钙蛋白Ⅰ的改变及其对预后的评估

Prognostic Value of Serum Troponin I in Acute Pulmonary Embolism

目的 :探讨血浆肌钙蛋白I(ScTnI)对急性肺血栓栓塞预后的评估价值。方法 :分析我院近 4年确诊急性肺血栓栓塞并行ScTnI检查的患者共 3 3例 ,分为ScTnI <0 1ng/ml组 (n =2 0 )及ScTnI≥ 0 1ng/ml组 (n =13 ) ,分析ScTnI水平与转归的关系。结果 :ScTnI <0 1ng/ml组中大面积肺血栓栓塞 9例 ,次大面积 4例 ,非大面积 7例 ;合并低血压休克者 6例 ;治疗后 8例患者呼吸困难完全消失 ,11例呼吸困难基本消失 ;1例死亡。ScTnI≥ 0 1ng/ml组中大面积肺血栓栓塞 12例 ,次大面积 1例 ;合并低血压休克者 11例 ;治疗后 3例呼吸困难完全消失 ,3例呼吸困难基本消失 ,7例住院期间死亡。 2组间低血压休克发生率及病死率存在显著性差异 (P <0 0 1)。结论 :急性肺血栓栓塞ScTnI升高者预后差 ,住院期间低血压休克发生率及病死率显著升高。

Objective: To assess the value of serum cardiac troponin I(ScTnI)for prognosis of patients with acute pulmonary thromboembolism (PTE). Methods:Data of inpatients from 2000 as 2003 who conformed as acute PTE and had ScTnI detected were reviewed and divided into ScTnI<0.1 ng/ml group(n=20)and ScTnI≥0.1 ng/ml group(n=13).The prognosis of the two groups were evaluated. Results: There were 9 cases of massive PTE, 4 of sub-massive PTE and 7 of non-massive PTE in ScTnI <0.1 ng/ml group,6 of them were complicated with hypotensive shock. After treatment, dyspnea completely disappeared in 8,almost completely disappeared in 12,and one patient died. In ScTnI≥0.1 ng/ml group, 12 were of massive PTE, one of sub-massive PTE, 11 of them were complicated with hypotensive shock. After treatment, dyspnea completely disappeared in 3,almost completely in 3,7 died during hospital stay. There was significant difference in the mortality between the two groups (p<0.01). Conclusions: The level of ScTnI is significantly related to the prognosis of acute PTE.Patients with higher level of ScTnI have a higher mortality during hospital stay.