心脏型脂肪酸结合蛋白和氨基末端B型钠尿肽前体对血流动力学稳定的急性肺栓塞的临床意义及其预测价值  

The Clinical Significance and Predictive Value of Heart Type Fatty Acid Binding Protien and N-terminal Pro B-type Natriuretic Peptide in Acute Pulmonary Embolism Patients with Stable Hemodynamics

作　　者：周海依[1] 罗巍[2] 石向江 

机构地区：[1]湖南省长沙市中心医院胸二科,410000 [2]湖南省马王堆医院心血管二区 [3]邵阳市中心医院

出　　处：《实用心脑肺血管病杂志》2013年第6期37-39,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨心脏型脂肪酸结合蛋白(H-FABP)和血浆氨基末端B型钠尿肽前体(NT-proBNP)对血流动力学稳定的急性肺栓塞(APE)患者的临床意义及其预后的预测价值。方法选择2006年1月—2013年1月入住三家医院血流动力学稳定的APE患者114例,根据血清H-FABP测定值将其分为阳性组和阴性组,根据血浆NT-proBNP水平将其分为高NT-proBNP组和低NT-proBNP组。观察患者入院后的超声心动图、血生化、D-二聚体、休克、呼吸衰竭、死亡等指标。结果 H-FABP阳性组和阴性组右室舒张末内径(RVEDD)、肺动脉收缩压(PASP)、右室/左室舒张末内径(RVEDD/LVEDD),休克、呼吸衰竭发生率及病死率比较,差异有统计学意义(P<0.05);高NT-proBNP组与低NT-proBNP组休克、呼吸衰竭发生率及病死率比较,差异有统计学意义(P<0.05)。结论血清H-FABP和NT-proBNP能够很好地对血流动力学稳定的APE患者进行危险分层,预测不良事件的发生率。Objective To explore the clinical significance and evaluate the predictive value of heart type fatty acid binding protein（H-FABP） and N-terminal pro B-type natriuretic peptide（NT-proBNP） of acute pulmonary embolism patients with stable hemodynamics.Methods We selected January 2006 to January 2013 in three stable hospital hemodynamics of 114 patients with APE,according to the determination of serum H-FABP value which is divided into positive group and negative group,according to the level of plasma NT-proBNP can be divided into high NT-proBNP group and low NT-proBNP group.Ultrasound observation of patients admitted after the heartbeat,blood biochemistry,figure two D-dimer,shock,respiratory failure,death index.Results H-FABP positive group and negative group,right ventricular end diastolic diameter（RVEDD）,systolic pulmonary artery pressure（PASP）,right ventricular/left ventricular end diastolic diameter（RVEDD/LVEDD）,shock,respiratory failure rate and death rate comparison,the difference was statistically significant（P〈0.05）;high NT-proBNP group and low NT-proBNP group,shock,respiration failure rate and mortality rate comparison,the difference was statistically significant（P〈0.05）.Conclusion Both plasma H-FABP and NT-proBNP are good predictors for the major adverse events and therefore is useful for risk stratification in APE patients with stable hemodynamics.

关 键 词：肺栓塞 心脏型脂肪酸结合蛋白 利钠肽 脑 血流动力学 

分 类 号：R563.5[医药卫生—呼吸系统]