目的探讨观察急性肺栓塞患者肌钙蛋白Ⅰ(cTnⅠ)及氨基末端脑钠肽前体(NT-proBNP)与肺动脉压力之间的关系。方法选择102例肺栓塞患者,通过超声心动图测得肺动脉收缩压值(PASP)将其分为肺动脉高压组(>30 mm Hg)54例,肺动脉压正常组(≤3...目的探讨观察急性肺栓塞患者肌钙蛋白Ⅰ(cTnⅠ)及氨基末端脑钠肽前体(NT-proBNP)与肺动脉压力之间的关系。方法选择102例肺栓塞患者,通过超声心动图测得肺动脉收缩压值(PASP)将其分为肺动脉高压组(>30 mm Hg)54例,肺动脉压正常组(≤30 mm Hg)组48例。对所有入选的患者进行cTnⅠ、NT-proBNP和血气分析检测,观察cTnⅠ、NT-ProBNP在急性肺动脉栓塞患者中的临床意义及与肺动脉高压相关性。结果急性肺栓塞患者合并肺动脉高压组的cTnⅠ水平(0.0415±0.049 ng/ml)明显高于肺动脉压正常组(0.0255±0.0211 ng/ml),差异具有统计学意义(P<0.05);急性肺栓塞患者合并肺动脉高压组的NT-proBNP水平(2 696.3±1 933.38 pg/ml)明显高于肺动脉压正常组(465.7±226.48 pg/ml),差异具有统计学意义(P<0.05)。结论急性肺栓塞患者血清cTnⅠ和NT-proBNP的水平与是否合并肺动脉高压相关,cTnⅠ和NT-proBNP可作为急性肺动脉栓塞患者病情评估的可靠指标。展开更多
Background: Elevated troponin levels are an independent indicator of poor outcome in ischemic stroke. The authors performed a retrospective study to ascertain whether elevated cardiac troponin I (cTnI) influences outc...Background: Elevated troponin levels are an independent indicator of poor outcome in ischemic stroke. The authors performed a retrospective study to ascertain whether elevated cardiac troponin I (cTnI) influences outcome from intracerebral hemorrhage (ICH). Methods: Patients were included if they had a cTnI level measured and a head CT performed within 24 hours of presentation with a spontaneous ICH. Those with recent stroke, angina, or myocardial ischemia were excluded. CT scans were reviewed to determine the hematoma size, location, presence of intraventricular or subarachnoid hemorrhage, hydrocephalus, and midline shift. Results: Of the 729 ICH patients admitted over 4 years, 235 were included in the analysis. Most exclusions were for medical reasons or because of lack of a CT. Mortality was higher in the 18%with a peak cTnI level >0.4 ng/mL (58 vs 34%, p = 0.009) and having elevated cTnI was an independent predictor of in-hospital mortality (Exp [β] 3.68, 95%CI 1.2 to 11.2, p = 0.023). Three patients (1.2%)-died due to cardiac events, all of whom had an elevated cTnI level on admission. Conclusions: Elevated cardiac troponin I (cTnI) values occur frequently in ICH and are independently associated with higher in-hospital mortality. Although cardiac causes of death were higher in those with elevated cTnI levels, due to its very low frequency (1.2%) this finding remains preliminary.展开更多
文摘Background: Elevated troponin levels are an independent indicator of poor outcome in ischemic stroke. The authors performed a retrospective study to ascertain whether elevated cardiac troponin I (cTnI) influences outcome from intracerebral hemorrhage (ICH). Methods: Patients were included if they had a cTnI level measured and a head CT performed within 24 hours of presentation with a spontaneous ICH. Those with recent stroke, angina, or myocardial ischemia were excluded. CT scans were reviewed to determine the hematoma size, location, presence of intraventricular or subarachnoid hemorrhage, hydrocephalus, and midline shift. Results: Of the 729 ICH patients admitted over 4 years, 235 were included in the analysis. Most exclusions were for medical reasons or because of lack of a CT. Mortality was higher in the 18%with a peak cTnI level >0.4 ng/mL (58 vs 34%, p = 0.009) and having elevated cTnI was an independent predictor of in-hospital mortality (Exp [β] 3.68, 95%CI 1.2 to 11.2, p = 0.023). Three patients (1.2%)-died due to cardiac events, all of whom had an elevated cTnI level on admission. Conclusions: Elevated cardiac troponin I (cTnI) values occur frequently in ICH and are independently associated with higher in-hospital mortality. Although cardiac causes of death were higher in those with elevated cTnI levels, due to its very low frequency (1.2%) this finding remains preliminary.
