心脏彩超和心肌肌钙蛋白T及心电图评估急性肺栓塞临床价值  

The clinical value of echocardiography and cardiac troponin T in patients with acute pulmonary embolism

作　　者：史玉爽[1] 杨媚[2] 

机构地区：[1]荆州市第一人民医院,湖北荆州434000 [2]荆州市精神卫生中心,湖北荆州434000

出　　处：《临床医药实践》2015年第4期270-273,共4页Proceeding of Clinical Medicine

摘　　要：目的:探讨心肌肌钙蛋白T(c Tn T)和心脏彩超在评估急性肺栓塞预后中的意义,以及时而准确地诊断和治疗肺栓塞,改善患者预后,提高生存率。方法:选择2010年1月—2013年12月52例肺栓塞患者,入院后行心电图、心肌肌钙蛋白(c Tn T)及心脏彩超检查,评价其在急性肺栓塞预后中的临床价值。结果:心电图在急性肺栓塞预后的评估中没有重要的临床价值;超声心动图观察到舒张末期右室内径增大是肺栓塞出现严重并发症或危及生命的危险因素,未发现肺动脉压是肺栓塞预后的重要影响指标。c Tn T阳性与阴性患者出现右心功能障碍、大面积肺栓塞及严重并发症比较,差异均有统计学意义。多元回归分析表明肌钙蛋白T阳性是肺栓塞出现严重并发症的危险指标。结论:右心功能是决定急性肺栓塞预后的重要参数,右心功能是通过心脏彩超的检测来反映急性肺栓塞的预后;右心功能在一定程度上与心肌肌钙蛋白T相关,可评估急性肺栓塞的预后;心电图在反映右心功能方面特异性差,评估急性肺栓塞的预后临床价值不大。Objective：To investigate the effect of cardiac troponin T（ cTnT）and heart colour to exceed its significance in evaluating the prognosis of acute pulmonary embolism,and timely and accurate diagnosis and treatment of patients with pulmo-nary embolism,to improve the prognosis of patients and improve the survival rate. Methods：52 cases with pulmonary embolism between January 2010 in December 2013 by our institute of respiratory diseases diagnosis of,all of the patients in the hospital after electrocardiogram（ ECG）,myocardial troponin（ cTnT）and heart colour to exceed check,the data to evaluate the clinical value in prognosis of acute pulmonary embolism. Results：The ECG in acute pulmonary embolism without important clinical val-ue in the evaluation of prognosis. supersonic and enchanted the graph is observed end—diastolic right ventricular diameter in-creased pulmonary embolism risk factor for severe or life—threatening complications,pulmonary artery pressure was not found is important index for prognosis of pulmonary embolism. Positive and negative patients right heart function obstacle massive pul-monary embolism were significant difference of serious complications,multiple regression analysis showed that positive troponin T is pulmonary embolism risk index of the severe complications. Conclusion：Right heart function is one of the important param-eters determine the prognosis of acute pulmonary embolism,the detection of right heart function is through the heart colour to exceed to reflect the prognosis of acute pulmonary embolism. Right heart function to a certain extent,related to the cardiac tro-ponin T,can evaluate the prognosis of acute pulmonary embolism. Electrocardiogram（ ecg）in the right reaction specificity on heart function is poor,little clinical value to assess the prognosis of acute pulmonary embolism.

关 键 词：心肌肌钙蛋白T 心脏彩超 心电图 肺栓塞 

分 类 号：R563.5[医药卫生—呼吸系统]