生物标志物与急性肺栓塞危险分层及预后的关联性研究  

Relationship between biomarkers and risk stratification and prognosis of acute pulmonary embolism

作　　者：庞颖颖[1] 刘海涛[1] PANG Ying-ying;LIU Hai-tao(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院呼吸与危重症医学科,安徽蚌埠233004

出　　处：《中华全科医学》2022年第2期199-201,281,共4页Chinese Journal of General Practice

基　　金：安徽高校自然科学研究重点项目(KJ2019A0395);蚌埠医学院自然科学基金面上项目(BYKY18100)。

摘　　要：目的探究生物标志物对急性肺栓塞危险分层及预后的应用价值。方法选取2018年1月-2019年11月间蚌埠医学院第一附属医院收治的经多层螺旋CT肺动脉造影确诊急性肺栓塞患者90例为观察组,根据2014年《欧洲心脏病协会ESC指南》分为高危组(20例)、中危组(21例)及低危组(49例)。另选取50例同期年龄相似健康体检者为对照组。采用酶联免疫吸附法检测B型脑钠肽(BNP)水平,快速定量检测仪检测肌钙蛋白Ⅰ(TnI)水平,白蛋白钴结合实验终点比色法测定缺血修饰性白蛋白(IMA)水平。结果观察组血清BNP、TnI及IMA水平高于对照组,差异有统计学意义(均P<0.05);高危组血清IMA、TnI及BNP表达水平高于中低危组,中危组高于低危组,差异有统计学意义(均P<0.05);死亡组患者血清中IMA、TnI及BNP分别为86.23(82.06,92.17)U/mL、0.74(0.35,0.78)ng/mL、2.42(0.69,5.60)ng/mL,高于存活组的70.54(67.16,84.87)U/mL、0.05(0.01,0.57)ng/mL、0.63(0.17,2.71)ng/mL,差异有统计学意义(均P<0.05)。结论BNP、TnI及IMA能够反映出急性肺栓塞的危险分层及预后评估,值得临床借鉴。Objective To explore the application value of biomarkers in the risk stratification and prognosis of acute pulmonary embolism.Methods From January 2018 to November 2019,90 patients with acute pulmonary embolism diagnosed by multi-slice spiral CT pulmonary angiography were selected as the observation group.In accordance with the 2014 European Heart Association(The European Society of Cardiology,ESC)guidelines,the patients were divided into a high-risk group(20 cases),a moderate-risk group(21 cases)and a low-risk group(49 cases).Another 50 healthy subjects of similar age in the same period were selected as the control group.The levels of B-type brain natriuretic peptide(BNP),troponin I(TnI)and ischaemic modified albumin(IMA)were measured by enzyme-linked immunosorbent assay,rapid quantitative detector and albumin cobalt binding assay,respectively.Results The serum levels of BNP,TnI and IMA in the observation group were significantly higher than those in the control group(P<0.05).The median values of serum IMA,TnI and BNP in the high-risk group were 88.78(85.63,99.55)U/mL,0.73(0.19,0.85)ng/mL and 2.63(1.32,5.48)ng/mL,respectively,and the levels in the high-risk group were significantly higher than those in the middle-and low-risk groups.In addition,the expression level in middle-risk group was significantly higher than that in the low-risk group.The median values of IMA,TnI and BNP in the dead group were 86.23(82.06,92.17)U/mL,0.74(0.35,0.78)ng/mL and 2.42(0.69,5.60)ng/mL,respectively.The serum levels of BNP,TnI and IMA in the dead group were significantly higher than those in the survival group(all P<0.05).Conclusion BNP,TnI and IMA can reflect the risk stratification and prognosis of acute pulmonary embolism,which is worthy of clinical reference.

关 键 词：急性肺栓塞 缺血修饰性白蛋白 肌钙蛋白Ⅰ 相关性 

分 类 号：R563.5[医药卫生—呼吸系统]