超声心动图联合心肌损伤标记物检测对急性肺栓塞的诊断价值  

Diagnostic value of color echocardiography combined myocardial injury markers detection for acute pulmonary embolism

作　　者：邵婧 张淳[1] 刘玉梅[1] 赵梦 汪玉宝[1] SHAO Jing;ZHANG Chun;LIU Yu-mei;ZHAO Meng;WANG Yu-bao(Department of General Medicine,Central Hospital of Ezhou City,Ezhou,Hubei,436000,China)

机构地区：[1]湖北省鄂州市中心医院全科医学科,湖北鄂州436000

出　　处：《心血管康复医学杂志》2022年第3期326-330,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究超声心动图联合心肌损伤标记物检测对急性肺栓塞(APE)的诊断价值。方法:回顾性分析我院收治的103例APE患者(PE组),另选择同期于我院健康体检者103例(健康对照组)的临床资料。比较两组彩色多普勒超声心动图(CCDE)的左室舒张末期内径(LVEDd)、LVEF和心肌损伤标记物(MIM):血清心肌肌钙蛋白Ⅰ(cTnI)、B型利钠肽(BNP)、心脏型脂肪酸结合蛋白(H-FABP)水平,分析超声心动图联合心肌损伤标记物检测对APE的诊断价值。结果:与健康对照组比较,PE组LVEDd [(47.85±9.35)mm比(58.75±5.33)mm]、cTnI[(0.99±0.36)μg/L比(1.83±0.47)μg/L]、BNP [(65.19±10.75) pg/ml比(93.92±11.85) pg/ml]、H-FABP[(2.72±1.85) ng/ml比(6.70±1.52) ng/ml]水平均显著增加,LVEF[(68.69±10.06)%比(49.43±5.88)%]显著降低,P均=0.001。超声心动图联合心肌损伤标记物检测诊断急性肺栓塞可获得更高的灵敏度(95.15%),特异度(91.26%)和准确率(93.2%),较好一致性(Kappa=0.748);联合检测的特异度显著高于单独LVEF、LVEDd及H-FABP检测(91.26%比80.58%、62.14%、72.82%,P<0.05或<0.01),准确性显著高于单独LVEF、LVEDd、cTnI及H-FABP检测(93.20%比85.44%、77.18%、86.89%、82.04%,P<0.05或<0.01)。结论:超声心动图联合心肌损伤标记物检测对急性肺栓塞具有更高的诊断价值,有利于减少误诊、漏诊。Objective:To study diagnostic value of Color-coded Doppler echocardiography(CCDE)indexes combined myocardial injury markers(MIM)detection for acute pulmonary embolism(APE).Methods:Clinical data of 103 APE patients(PE group)treated in our hospital were retrospectively analyzed,and another 103 healthy volunteers undergoing physical examination in our hospital simultaneously were selected as healthy control group.CCDE indexes[left ventricular end-diastolic dimension(LVEDd),LVEF]and MIM(myocardial injury markers)levels[serum cardiac troponin I(cTnI),B-type natriuretic peptide(BNP),heart type fatty acid-binding protein(H-FABP)]were compared between two groups,and diagnostic value of CCDE combined MIM detection for APE was analyzed.Results:Compared with healthy control group,there were significant rise in LVEDd[(47.85±9.35)mm vs.(58.75±5.33)mm],levels of cTnI[(0.99±0.36)μg/L vs.(1.83±0.47)μg/L],BNP[(65.19±10.75)pg/ml vs.(93.92±11.85)pg/ml]and H-FABP[(2.72±1.85)ng/ml vs.(6.70±1.52)ng/ml],and significant reduction in LVEF[(68.69±10.06)%vs.(49.43±5.88)%]in PE group,P=0.001 all.CCDE combined MIM detection possesses higher sensitivity(95.15%),specificity(91.26%),and accuracy(93.2%)with good consistency(Kappa=0.748)in diagnosing APE;specificity of combined detection was significantly higher than single LVEF,LVEDd and H-FABP detection(91.26%vs.80.58%,62.14%,72.82%,P<0.05 or<0.01),and its accuracy was significantly higher than single LVEF,LVEDd,cTnI and H-FABP detection(93.20%vs.85.44%,77.18%,86.89%,82.04%,P<0.05 or<0.01).Conclusion:Color echocardiography combined myocardial injury markers detection possesses higher diagnostic value for acute pulmonary embolism,which helps to reduce misdiagnosis and missed diagnosis.

关 键 词：肺栓塞 超声心动描记术 多普勒 彩色 肌钙蛋白Ⅰ 

分 类 号：R563.5[医药卫生—呼吸系统]