肌钙蛋白联合血气分析对肺栓塞诊断及危险分层的探讨  

Evaluation of serum cardiac troponin I combined with arterial blood gas analysis in diagnosis of acute pulmonary embolism and risk stratification

作　　者：骆黎[1] 吴晓贞[1] 邓春发[1] 

机构地区：[1]襄阳市中心医院急诊科,湖北襄阳441021

出　　处：《临床急诊杂志》2011年第1期19-21,共3页Journal of Clinical Emergency

摘　　要：目的:通过联合检测血浆肌钙蛋白I(cTnI)和血气分析,探讨其结果对急性肺栓塞(APE)患者进行诊断及危险分层的意义。方法:根据cTnI水平和血气分析阳性结果将61例APE患者分为3组:A组(12例):cTnI<0.05μg/L且血气分析结果为阴性;B组(27例):cTnI≥0.05μg/L或血气分析结果为阳性;C组(22例):cTnI≥0.05μg/L且血气分析结果为阳性。分析cTnI和血气分析阳性结果与APE患者诊断与危险分层的关系。结果:3组中D-二聚体阳性率C组、B组较A组升高(P<0.05)。其中C组,其右心室扩大及肺动脉高压的发生率明显高于A组(P<0.01),较B组发生率增高,但差异无统计学意义。B组较A组右心室扩大及肺动脉高压的发生率明显增高(P<0.05)。病死率及心源性休克的发生率C组明显高于A组(P<0.01),B组高于A组(P<0.05)。C组大面积APE的发生率较A组、B组明显增高,差异有统计学意义(P<0.01或P<0.05)。结论:联合检测cTnI和血气分析在APE的诊断和分层中具有重要意义。Objective：To evaluate the diagnostic value and risk stratification of serum cardiac troponin I and arterial blood gas analysis in acute pulmonary embolism.Method：According to the degree of serum cardiac troponin I and arterial blood gas analysis,61 patients with acute pulmonary embolism were divided into three groups：Group A（n=12）：ScTnI0.05 μg/L and the negative arterial blood gas analysis result;Group B（n=27）：ScTnI≥0.05 μg/L or the positive arterial blood gas analysis result;Group C（n=22）：ScTnI≥0.05 μg/L and the positive arterial blood gas analysis result.Result：The positive incidence of D-Dimer in group C and B were higher than group A（P〈0.05）.The incidence of right ventricular dilation and pulmonary arterial hypertension in group C was significantly higher than group A（P〈0.01）.This incidence in group C was higher than group B without significant statistical meaning.The incidence of right ventricular dilation and pulmonary arterial hypertension in group B was higher than group A（P〈0.05）.The incidence of cardiogenic shock and mortality in group C was significantly higher than group A（P〈0.01）,and was higher in group B than group A（P〈0.05）.The incidence of large area pulmonary embolism in group C was significantly higher than group B and group A（P〈0.01,P〈0.05,respectively）.Conclusion：Combined detection of ScTnI and arterial blood gas analysis has important value for the diagnosis and risk stratification of acute pulmonary embolism.

关 键 词：肺栓塞 急性 肌钙蛋白 血气分析 危险分层 

分 类 号：R563.5[医药卫生—呼吸系统]