NT—proBNP与cTnI在评估老年中高危肺栓塞合并右心功能障碍患者病情中的应用价值  

Application value of NT-proBNP and cTnI in evaluating severity of acute intermediate or high risk pulmonary embolism complicated with right ventricular dysfunction in elderly patients

作　　者：张莹[1] 买丁·都生拜[2] 刘晖[1] 

机构地区：[1]新疆医科大学第一附属医院呼吸二科,乌鲁木齐830054 [2]新疆医科大学附属肿瘤医院病案管理科,乌鲁木齐830054

出　　处：《国际呼吸杂志》2017年第11期830-834,共5页International Journal of Respiration

摘　　要：目的探讨血浆N末端B型利钠肽原（NT—proBNP）、心肌肌钙蛋白I（cTnI）在评估老年急性中高危肺栓塞合并右心功能障碍患者病情中的应用价值。方法选取2015年1月至2016年6月新疆医科大学第一附属医院收治的老年急性中高危肺栓塞合并右心功能障碍的59例患者作为合并组，另选取85例未发生右心功能障碍的老年急性中高危肺栓塞患者作为非合并组，以及50名体检健康者作为对照组。采集所有研究对象清晨空腹外周静脉血，应用免疫荧光法测定患者血浆NT—proBNP及cTnI指标，采集血液标本的同时进行超声心动图检查，对比各组NT-proBNP、cTnI指标的差异性，并应用特征曲线分析影响急性中高危肺栓塞患者临床预后结局的主要因素。结果3组NT—proBNP、cTnI指标比较差异均有统计学意义（P值均〈0．05），并且合并组患者右心室舒张末期内径明显高于非合并组与对照组（P值均〈0．05）。受试者工作特征曲线显示NT-proBNP、cTnI曲线下面积均大于90％，logistic回归分析显示NT—proBNP、cTnI指标、右心功能障碍与患者临床预后具有密切联系。结论NT—proBNP、cTnI指标不仅在诊断急性中高危肺栓塞合并右心功能障碍中具有重要意义，同时能够对患者的临床预后转归提供良好、准确的评估，可作为指导肺栓塞患者临床治疗的简单、灵敏的标志物。Objective To investigate the application value of plasma N-terminal B-type natriuretic peptide （NT-proBNP） and cardiac troponin I （cTnI） in the assessment of elderly patients with acute intermediate or high risk pulmonary embolism complicated with right ventricular dysfunction. Methods 59 elderly patients with acute intermediate or high risk pulmonary embolism complicated with right ventricular dysfunction in the first affiliated hospital of Xinjiang medical university from January 2015 to June 2016 were selected as combined group, 85 elderly cases of acute intermediate or high risk pulmonary embolism without right ventricular dysfunction were selected as non- combined group, and 50 healthy persons as control group. The fasting peripheral vein blood was collected to determine NT-proBNP and cTnI by immunofluoreseence method, while echocardiography was performed. The main prognostic factors of acute intermediate or high risk pulmonary embolism were analyzed by characteristic curve. Results There was significant difference in NT-proBNP and eTnI among the three groups （all P 〈 0.05）. The right ventricular end diastolic inner diameter in combined group was significantly higher than that in non-combined group and control group （all P d0.05）. The receiver operating characteristic curve showed that the area under curve of NT-proBNP and cTnI was greater than 90 ~. Logistic regression analysis showed that NT-proBNP, cTnI, and right ventricular dysfunction were closely related to the clinical prognosis of acute intermediate or high risk pulmonary embolism. Conclusions NT-proBNP and cTnI not only have important significance in the diagnosis of acute intermediate or high risk pulmonary embolism complicated with right ventricular dysfunction, hut also provide accurate assessment for the prognosis of the patients, which can be simple and sensitive biomarkers to guide clinical treatment of pulmonary embolism.

关 键 词：N末端B型利钠肽原 心肌肌钙蛋白I 老年急性中高危肺栓塞 右心功能障碍 病情评估 

分 类 号：R563.5[医药卫生—呼吸系统] R541[医药卫生—内科学]