NT-proBNP测定在次大面积肺栓塞溶栓治疗中的意义  

The prognostic value of NT-proBNP testing in thrombolysis therapy of acute pulmonary thromboembolism

作　　者：李琳[1] 陈旭锋[1] 黄培培[1] 蒋雷[1] 娄爽[1] 康健[1] 张劲松[1] 

机构地区：[1]南京医科大学第一附属医院急诊科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2014年第5期645-648,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省人民医院新技术项目(2011)

摘　　要：目的:探讨NT-proBNP测定在急性肺血栓栓塞症溶栓治疗中的意义。方法:将62例血流动力学稳定的次大面积肺血栓栓塞症患者分为溶栓组与非溶栓组,比较两组间治疗前后临床表现、生命体征及预后的差异,并进一步以外周血NTproBNP是否增高分组,比较组间上述统计指标的差异。结果 :溶栓组与非溶栓组相比,治疗前后心率、收缩压、呼吸频率、DDimer、PaO2变化的差异不明显,胸闷症状改善率及临床不良事件发生率两组间无显著差别。NT-proBNP增高的患者溶栓组心率、收缩压、呼吸频率、D-Dimer、PaO2的改善显著优于非溶栓组,胸闷改善率及临床不良事件率均优于非溶栓组;NT-proBNP正常的患者溶栓组与非溶栓组相比,上述指标差异不明显。非溶栓治疗的患者中,NT-proBNP正常的患者心率、收缩压、PaO2的改善优于NT-proBNP增高的患者,不良事件发生率显著低于NT-proBNP增高的患者;而溶栓治疗的患者,NT-proBNP增高组与NT-proBNP正常组上述指标无显著差异。结论:溶栓治疗可以改善NT-proBNP增高的次大面积肺栓塞患者的预后,但对NTproBNP正常的患者预后改善不明显。Objective：To observe the prognostic value of NT-proBNP testing in thrombolysis therapy in acute pulmonary thromboembolism. Methods：Sixty-two hemodynamically stable patients with acute pulmonary thromboembolism were randomly divided into thrombolysis therapy[TT（＋）] group and non-thrombolysis therapy[TT（-）] group. The clinical aspects,vital sign,prognosis before and after thrombolysis treatment were compared between the two groups. And patients were divided into two groups based on serum NT-proBNP level. Clinical indicators of the two groups were compared. Resules：The difference of heart rate,systolic blood pressure,respiratory rate,D-dimer level,PaO2 level before and after treatment had no significant difference between TT （＋） group and TT （-） group. Chest symptoms improvement rate and clinical adverse events rate had no significant difference. In patients with high NT-proBNP level,the improvement of heart rate,systolic blood pressure,respiratory rate,D-dimer level,PaO2 level,and chest symptoms improvement rate,clinical adverse events rate in TT （＋） group were significantly better than those of TT （-） group. But in patients with normal NT-proBNP level,the clinical indicators had no significant difference. In patients without thrombolytic therapy,the improvement of heart rate,systolic blood pressure,PaO2 level in NT-proBNP normal group was significantly better than NT-proBNP increase group,while clinical adverse events rate was significantly lower than NT-proBNP increase group. But in patients undergo thrombolytic therapy,the difference between NT-proBNP normal group and NT-proBNP increase group was not significantly. Conclusion：Thrombolytic therapy can improve the prognosis of patients with high NT-proBNP level,but in patients with normal NT-proBNP level,the improvement is not obvious.

关 键 词：NT—proBNP 肺血栓栓塞症 溶栓 

分 类 号：R563.5[医药卫生—呼吸系统]