摘要
目的探讨右心功能、脑钠肽（BNP）及心肌肌钙蛋白I（cTnI）对非高危急性肺栓塞（APE）患者危险分层的临床价值。方法入选2010年1月～2013年6月确诊的非高危APE患者60例，根据有无右心功能不全及血浆cTnI、BNP水平将人选患者分为3组。中高危组（15例）：右心功能不全，cTnI≥0．1μg／L和／或BNP≥100ng／L；中低危组（30例）：或存在右心功能不全，或存在cTnI≥0．1μg／L、BNP≥100ng／L中的至少一项；低危组（15例）：右心功能正常，cTnI〈0．1μg／L且BNP〈100ng／L。分析右心功能、cTnI、BNP水平与APE患者危险分层和临床预后的关系。结果中高危组、中低危组、低危组的30d临床不良事件发生率分别为33．3％、20．0％、0．0％，病死率分别为13．3％、6．7％、0．0％，差异有统计学意义（P〈0．05）；中高危组和中低危组的cTnI、BNP水平明显高于低危组，中高危组的cTnI、BNP水平与中低危组相比亦明显增高，差异均有统计学意义（P〈0．05）。结论右心功能及血浆cTnI、BNP水平在APE患者危险分层中具有重要的临床价值。
Objective To explore the clinical value of right ventricular function,brain natriuretic peptide （BNP）and cardiac troponin I （cTn I ） on risk stratification in non high risk patients with acute pulmonary embolism（APE）. Methods 60 patients with non high risk APE diagnosed from January 2010 to June 2013 were selected and divided into intermediate-high risk group （15 cases）, intermediate-low risk group （30 cases） and low-risk group （15 cases） based on right ventricular function, cTn I and BNP level. Intermediate-high risk group： fight ventricular dysfunction （RVD）, one of the cTn I ≥0.1 μg/L and BNP ≥ 100 ng/L at least; intermediate-low risk group： RVD or cTn I ≥0.1 μg/L and/or BNP≥ 100 rig/L; low-risk group：normal right ventricular function, cTn I 〈0.1 μg/L and BNP〈IO0 ng/L.Right ventricu- lar function, plasma BNP and cTn I level were detected. Relationship among right ventricular function, BNP, cTn I level and risk stratification of APE patient, clinical outcome were analyzed. Results Incidence rate of clinical adverse event at 30 days in intermediate-high risk group, intermediate-low risk group and low-risk group was 33.3%, 20.0%, 0.0% respectively,mortality rate of intermediate-high risk group, intermediate-low risk group and low-risk group was 13.3%, 6.7%, 0.0% respectively, with statistical differences （P 〈 0.05）. cTn I and BNP level of intermediate-high risk group and intermediate-low risk group was significantly higher than that of low-risk group respectively, cTn I and BNP level of intermediate-high risk group was significantly higher than that of intermediate-low risk group respectively, with statistical differences （P 〈 0.05）. Conclusion Right ventricular function, cTn I and BNP level have important clinical value for risk stratification in the non high risk patients with acute pulmonary embolism.
出处
《中国医药导报》
CAS
2015年第14期8-10,14,共4页
China Medical Herald
基金
国家自然科学基金资助项目(81273948)
河南省高校科技创新团队支持计划(13IRTSTHN012)(C20130050)
关键词
急性肺栓塞
脑钠肽
心肌肌钙蛋白I
右心功能
危险分层
Acute pulmonary embolism
Brain natriuretic peptide
Cardiac troponin I
Right ventricular function
Riskstratification
