血浆B型脑钠肽结合D-二聚体对肺栓塞预后评估的临床价值  

Prognostic Values of B- type Natriuretic Peptide and D-dimer Level in Plasma in Acute Pulmonary Embolism

作　　者：魏卿[1] 王昌明[2] 

机构地区：[1]彭州市人民医院重症监护室,611930 [2]彭州市人民医院呼吸内科,611930

出　　处：《医学研究杂志》2015年第11期143-146,共4页Journal of Medical Research

摘　　要：目的探讨血浆B型脑钠肽（BNP）结合D-二聚体（D—dimer）在评价急性肺栓塞（APE）患者临床预后的价值。方法以笔者医院2010年1月～2014年12月确诊的APE患者150例为研究对象，采用酶联免疫吸附法分别测定外周血BNP及D—dimer浓度。根据病情严重程度将APE患者分为低危组、中危组及高危组；根据临床转归，将其分为存活组及死亡组，比较不同组间BNP和D—dimer水平差异，评价BNP和D—dimer对评估APE患者预后的预测价值。结果随着APE病情严重程度的增加，BNP和D—dimer指标水平显著升高（P〈0．05）；死亡组BNP和D—dimer水平显著高于存活组（P〈0．05）。相关性分析显示，血浆BNP与D～dimer水平呈正相关（r=0．735，P=0．000）。ROC曲线分析显示，BNP和D—dimer曲线下面积均较大（〉85％），其最佳工作点分别为0．85ng／L和0．92mg／L。结论BNP联合D—dimer可有效的预测APE患者病情严重程度及预后，其可为临床个体化治疗，降低APE患者病死率提供客观依据。Objective To evaluate the clinical value of B - type natriuretic peptide （BNP） and D - dimer in the prognosis of acute pumonary embolism （APE）. Methods Totally 150 patients diagnosed with APE from January 2010 to December 2014 were enrolled in this study. The level of plasma BNP and D - dimer were assessed by enzyme - linked immunosorbent assay. According to severity of dis- ease, the APE patients were divided into low - risk, middle - risk and high - risk group. According to the clinical prognosis, the APE pa- tients were divided into survical and death group. The BNP and D - dimer level in different groups and the correlation with the prognosis were compared. Results With the increased serious degree in patients, the BNP and D - dimer level were significantly increased （P 〈 0.05） ; the BNP and D - dimer level were significantly higher in death group than survival group （P 〈 0.05 ）. The BNP and D - dimerlevel were positively correlated （ r = 0. 735 ,P = 0. 000）. ROC curves analysis results showed that the area under curve of BNP and D - di- mer were large （ 〉 85% ）. The optimal operating point （OOP） for BNP and D - dimer were 0.85ng/L and 0.92mg/L, respectively. Conclusion The BNP and D - dimer can effectively assess serious degree and prognosis of APE patients, meanwhile, it also provides an objective basis for the clinical individual treatment and decreases the mortality rate of APE patients.

关 键 词：B型脑钠肽 D-二聚体 肺栓塞 预后 

分 类 号：R543[医药卫生—心血管疾病]