急性肺栓塞患者BNP、CTnI、D-dimer水平改变及其临床意义  

Changes of the Levels of BNP, CTnI and D-dimer in Patients with Acute Pulmonary Embolism and Their Significance

作　　者：陈芳[1] 刘智玲[1] 韩小彤[1] 

机构地区：[1]湖南省人民医院急诊科,湖南长沙410002

出　　处：《医学临床研究》2014年第10期2014-2017,共4页Journal of Clinical Research

摘　　要：【目的】探讨检测急性肺栓塞患者的血浆脑钠肽（BNP）、肌钙蛋白I（cTnI）及D‐二聚体（D‐dimer）水平变化的临床意义。【方法】选择本院2009年1月至2013年12月收治的急性肺栓塞患者64例，根据患者病情分为大面积肺栓塞组（ n ＝27）和非大面积肺栓塞组（ n ＝37），对两组患者血浆cTnI、BNP及D‐dimer水平进行测定，观察比较两组患者各指标水平的变化及右心功能和病死率。【结果】大面积肺栓塞组BN P、血浆cTnI水平明显高于非大面积肺栓塞组，两组比较差异有显著性（ P ＜0．05）；两组D‐dimer浓度比较差异无统计学意义（ P ＞0．05）；大面积肺栓塞组的右心功能不全者和病死率均高于非大面积肺栓塞组，两组比较差异有统计学意义（ P ＜0．05）。【结论】检测BNP、cTnI及D‐dimer水平对APE患者临床诊断、临床决策及预后判断具有重要的临床意义。[Objective] To explore the clinical significance of the changes of plasma levels of brain natriuretic peptide（BNP） ,troponin I（cTnI ） and D‐dimer（D‐dimer） in patients with acute pulmonary embolism （APE）. [Meth‐ods]A total of 64 patients with acute pulmonary embolism admitted to our hospital from Jan. 2009 to Dec. 2013 were selected. According to the patients＆#39;condition ,all patients were divided into massive pulmonary embolism group （ n=27） and non‐massive pulmonary embolism group （ n = 37）. The plasma levels of cTnI ,BNP and D‐dimer in two groups were measured. The changes of all above indicators ,right ventricular function and fatality rate were compared between two groups. [Results]The levels of BNP and cTnI in the massive pulmonary embolism group were obviously higher than those in the non‐massive pulmonary embolism group ,and there were significant differences （ P〈0. 05）. There was no significant difference in D‐dimer between two groups （ P〉0. 05）. The number of patients with right ventricular function and fatality rate in the massive pulmonary embolism group were higher than those in the non‐mas‐sive pulmonary embolism group ,and there were significant differences （ P〈0. 05）. [Conclusion] The levels of BNP , cTnI and D‐dimer are of important clinical significance in clinical diagnosis ,therapeutic decision‐making and prognosis judgment of APE patients.

关 键 词：肺栓塞/代谢 急性病 促尿钠排泄剂/血液 肌钙蛋白I/血液 纤维蛋白纤维蛋白原降解物/分析 

分 类 号：R563.5[医药卫生—呼吸系统]