脑钠肽对老年中央型肺栓塞的预测价值  

Study of Predictive Value of Brain Natriuretic Peptide in Elderly Patients with Central Pulmonary Embolism

作　　者：王青松[1] 张艳敏[1] WANG Qingsong;ZHANG Yanmin(Department of Cardiac Medicine,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院心脏内科

出　　处：《医学综述》2019年第21期4355-4358,4363,共5页Medical Recapitulate

基　　金：承德市科学技术研究与发展计划项目(201601A024)

摘　　要：目的探讨脑钠肽(BNP)对老年中央型肺栓塞的预测价值。方法选取2016年1月至2019年2月在承德医学院附属医院住院的108例老年(年龄>60岁)急性肺血栓栓塞症(APTE)患者作为研究对象,根据CT肺动脉造影检查结果分为中央型肺栓塞组(61例)和周围型肺栓塞组(47例)。观察并记录患者的右心室内径、氧分压、二氧化碳分压、BNP、D-二聚体、中性粒细胞与淋巴细胞比值(NLR)。结果中央型肺栓塞组的BNP水平高于周围型肺栓塞组[515.2(180.5,752.0)ng/L比79.6(45.6,107.5)ng/L](P<0.05)。BNP预测老年中央型肺栓塞的受试者工作特征曲线下面积为0.933(95%CI 0.873~0.993),约登指数为0.748,当BNP的界值为170.00 ng/L时,其灵敏度为78.8%,特异度为96.0%。结论BNP>170.00 ng/L可作为预测老年中央型肺栓塞的指标。Objective To explore the predictive value of brain natriuretic peptide(BNP)in elderly patients with central pulmonary embolism.Methods A total of 108 elderly patients(aged>60 years)with acute pulmonary thromboembolism(APTE)hospitalized in Affiliated Hospital of Chengde Medical College from Jan.2016 to Feb.2019 were included in the study.According to the results of CT pulmonary angiography,the patients were divided into a central pulmonary embolism group(61 cases)and a peripheral pulmonary embolism group(47 cases).The right ventricular diameter,oxygen partial pressure,carbon dioxide partial pressure,BNP,D-dimer,neutrophil-to-lymphocyte ratio(NLR)were observed and recorded.Results The level of BNP in the central pulmonary embolism group was higher than that in the peripheral pulmonary embolism group[515.2(180.5,752.0)ng/L vs 79.6(45.6,107.5)ng/L](P<0.05).BNP predicted area under curve of the elderly patients with central pulmonary embolism was 0.933(95%CI 0.873-0.993),and the Yoden’s index was 0.748.When the cutoff value of BNP was 170.00 ng/L,the sensitivity and specificity were 78.8%and 96.0%respectively.Conclusion BNP>170.00 ng/L can be used as a predictor of central pulmonary embolism in the elderly.

关 键 词：中央型肺栓塞 老年患者 脑钠肽 预测价值 

分 类 号：R563.5[医药卫生—呼吸系统]