摘要
目的探讨BNP（B型尿钠肽）在急性肺栓塞早期病情评估中的意义。方法选择2005年11月至2010年6月北京友谊医院资料完全的急性肺栓塞病例86例进行回顾性分析，根据有无右心功能障碍分为两组，比较两组间BNP等相关指标间的差异，并行BNP与RV—RAPG（右心房和右心室的压力梯度值）之间的相关性分析；根据有无并发症分为两组，比较两组间BNP等相关指标间的差异。结果（1）右心功能障碍与右心功能正常的患者，组间比较采用两组间配对t检验，两组BNP分别为（320．4±190．5）pg／mlVS．（51．5±30．79）pg／ml，P〈0．05，差异具有统计学意义。（2）BNP与右心功能RV—RAPG行线性相关分析，两组间有较好的相关性（r=0．824，P〈0．01）；（3）BNP预测右心功能障碍ROC曲线分析，ROC曲线下面积（AUC值）0．907，表明BNP能较好预测右心功能障碍情况；（4）有并发症的患者与无并发症的患者，组间比较采用两组间配对t检验，两组间BNP分别为（1356．8±675．4）pg／ml vs．（103．8±51．4）pg／ml，P〈0．05，差异具有统计学意义；两组间pH分别（7．372±3．7）vs．（7．446±3．5），P〈0．05，差异具有统计学意义。结论（1）BNP在急性肺栓塞患者的早期诊疗中，对预测患者右心衰的发生及病情的严重程度和预后有着积极的临床意义（2）早期的动脉血气pH值在急性肺栓塞患者的早期诊疗中，对预测病情的严重程度和预后有着积极的参考价值。
Objective To explore the role of BNP （B-type natriuretic peptide ） in the early assessment of patients with acute pulmonary embolism （PE） . Methods Eighty-six patients hospitalized in Beijing Friendship Hospital from November 2005 to June 2010 diagnosed as acute PE were studied retrospectively. The differences of BNP and other indicators and the relationship of BNP and fight ventricular and right atrial pressure gradient value （ RV-RA PG） were compared between two groups divided by whether right ventricular dysfunction exists or not. imilarly, the differences of BNP and other indictors were compared between the two groups divided by complications exists or not. Results In the right ventricular dysfunetion group and control group, BNP was （ 1356. 8 ±675.4） pg/ml and （ 103.8±51.4） pg/ml, respectively, and the differences are significant. BNP and RV-RA PG had a significant correlation （r =0. 824, P 〈0.01） by Linear correlation analysis. BNP had a reliable diagnostic power for right ventricular dysfunction （ AUC 0. 907 ）. In the group with complications and none -complication group, BNP value was （1356. 8 ±675.4） pg/mlvs. （103.8±51.4） pg/ml, and pH value was （7.372±3.7） vs. （7.446±3.5）, and the differences were all significant （P 〈 0. 05 ）. Conclusions BNP has important significance in early predicting the occurring, severity and prognosis of congestive heart failure caused by acute pulmonary embolism; pH of the early arterial blood gas has positive significance for early diagnose and treatment and predicting the severity and prognosis of patients suffering acute pulmonary embolism.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2012年第6期638-641,共4页
Chinese Journal of Emergency Medicine
关键词
急性肺栓塞
B型尿钠肽
肌钙蛋白’
纤维蛋白降解产物
D-二聚体
C反应蛋
白
右心室功能
评估
预后
Acute pulmonary embolism
Brain natriaretie peptide
Troponin I
Fibrin degredation product
D-Dimer
C-reactive protein
Right ventricular function
Assessment
Prognosis
