肌钙蛋白T对急性肺血栓栓塞症患者预后评估价值  

Prognostic value of elevated cardiac troponin T levels in acute pulmonary thromboembolism

作　　者：马海英[1] 王承敏[1] 

机构地区：[1]大连市中心医院呼吸科,辽宁大连116033

出　　处：《大连医科大学学报》2006年第3期205-207,共3页Journal of Dalian Medical University

摘　　要：[目的]探讨肌钙蛋白T（cTnT）对急性肺血栓栓塞症（PTE）患者的预后评估价值。[方法]确诊为急性肺血栓栓塞症病例35例，比较cTnT（4-）组和cTnT（-）组间右室／左室（RV／LV）舒张末直径、肺动脉高压发生率、血氧分压、临床不良事件发生率、体循环平均压的差异性。[结果]56．5％急性大面积和次大面积PTE患者有血浆中cTnT的水平升高，非大面积PTE中cTnT的水平正常。cTnT（＋）组肺动脉高压发生率增加显著（39．2％对比16．4％，P〈0．05），体循环平均压下降显著（110．9±22．3对比129．4±20．1，P〈0．05），临床不良事件发生率显著增加（41．7％对比5．2％，P〈0．01），RV／LV舒张末直径值显著增加（1．21±0．24对比0．87±0．23，P〈0．01），升高的cTnT是发生临床不良事件的独立危险因素，其相对危险度（OR）和95％可信区间分别为21．2（2．7．200）。[结论]急性大面积和次大面积PTE患者多有血浆中cTnT的水平升高，cTnT的水平升高，右室功能不全发生率高，强烈提示预后不良。[Objective]To evaluate cardiac troponinT （cTnT） in the prognosis in acute pulmonary thromboembolism （PTE）. [ Methods] Thirty-five patients with acute pulmonary thromboembolism were included in the study. The end diastolic RV/LV, rate of pulmonary hypertention, mean systemic blood pressure , oxygen pressure and clinical adverse outcome were compared in patients with elevated levels of serum cTnT versus patients with normal levels of serum cTnT. [ Results] Serum cTnT levels in 56.5 % massive and sub- massive PTE were increased, Serum cTnT levels in non - massive PTE were nomal. Rate of pulmonary hypertention was statistically higher in the cTnT（ ± ） group compared to cTnT（ - ）group （39.2% vs 16.4%, P 〈 0.05）, Mean systemic blood pressure decreased significantly in the patients with elevated serum cTnT levels （110.9±22.3 vs 129.4±20.1, P〈0.05）,The end diastohc RV/LV was significantly higher in the cTnT - positive group（ 1.21 ± 0.24 vs 0.87 ± 0.23, P 〈 0.01 ）, and chnical adverse outcome was significantly higher in the cTnT positive group （41.7% vs 5.2%, P 〈 0.01）, The elevated cTnT was an independent risk facter for adverse clinical events （ OR 21.2, 95% CI 2.7 - 200）. [Conclusion] Serum cTnT levels in most massive and sub- massive PTE are increased. Patients with elevated serum cTnT levels are at a higher risk for the development of right ventricular dysfunction and clinical adverse outcome.

关 键 词：肺血栓栓塞症 肌钙蛋白T 预后 

分 类 号：R563.5[医药卫生—呼吸系统]