γ-谷氨酰转肽酶对急性肺栓塞早期病死率的预测价值  

Value of γ-glutamyl transferase levels in prediction of early mortality in patients with acute pulmonary embolism

作　　者：叶广林 郭继全 黄燕莹[1,2] 

机构地区：[1]广东省人民医院呼吸内科 [2]广东省医学科学院,广州510080

出　　处：《岭南心血管病杂志》2013年第6期664-667,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨γ-谷氨酰转肽酶(γ-glutamyl transferase,GGT)与急性肺动脉栓塞(acute pulmonary embolism,APE)患者早期病死率之间的关系。方法共入组了109例确诊为APE的患者。使用受试者工作曲线(ROC)得出GGT的最佳预测早期病死率临界值为>52 IU/L,敏感性91.7%和特异性61.9%。APE患者在GGT临界值的基础上分为没有增加(I组)或增加(II组),对两组基线特征、血流动力学、超声心动图及实验室检查结果进行比较。结果109例患者中,13例(11.9%)在住院期间死亡。在这13例患者中,有2例(3.2%)进入I组,11例(23.9%)进入Ⅱ组,差异有统计学意义(P=0.001)。GGT与入院时心率(r=0.502,P<0.001)、收缩压(r=-0.505,P<0.001)、舒张压(r=-0.296,P=0.002)、动脉血氧分压(r=-0.477,P<0.001)、三尖瓣关闭不全的严重程度(r=0.348,P=0.001)、肌钙蛋白I(r=0.369,P=0.035)相关。结论 GGT升高的急性APE患者早期死亡风险明显升高。GGT升高与较差的血流动力学指标相关。GGT可能有助于APE患者的危险分层。Objectives To investigate the relationship between γ-glutamyl transferase （GGT） and early mortality in patients with acute pulmonary embolism （APE）. Methods Totally 109 consecutive patients with confirmed APE were evaluated. The optimal cutoff value of GGT to predict early mortality was measured by ROC curve as more than 52 IU/L with 91.7% sensitivity and 61.9% specificity. Patients with APE were categorized prospectively as having no increased （group I） or increased （group II） GGT based on a cutoff value. Baseline characteristic, hemodynamics and result of uhrasound cardiography between the two groups were compared. Results Of the 109 patients, 13 patients （11.9%） died in hospital. Among these 13 patients, 2 （3.2%） patient were in group I, and 11 （23.9%） patients were in group II （P=0.001）. GGT levels were correlated with admission heart rate（r=0.502, P〈0.001 ）, systolic blood pressure （r=-0.505, P〈0.001 ）, diastolic blood pressure （r=-0.296, P=0.002）, oxygen tension （r=-0.477, P〈0.001）, severity of tricuspid regurgitation （r=0.348, P=0.001） and troponin I levels （r=0.369, P=0.035）. Conclusions Patients with increased GGT has a higher early mortality risk. Higher GGT level is associated with worse hemodynamic parameters, and GGT can help with the risk stratification in patients with APE.

关 键 词：急性肺栓塞 Γ-谷氨酰转肽酶 早期病死率 

分 类 号：R543.2[医药卫生—心血管疾病]