中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2009年
18期
1-3
,共3页
心肌肌钙蛋白T%心脏彩超%心电图%肺栓塞
心肌肌鈣蛋白T%心髒綵超%心電圖%肺栓塞
심기기개단백T%심장채초%심전도%폐전새
Cardiac Troponin T%Echocardiography%ECG%Pulmonary embolism
目的 探讨心肌肌钙蛋白T(cTnT)和心脏彩超在评估急性肺栓塞预后中的意义,以便及时准确地制定肺栓塞的治疗方案,改善患者的预后.方法 本研究的对象为广州呼吸疾病研究所105例已确诊为肺栓塞的病人,所有病人在入院24h内行心肌肌钙蛋白T(cTnT),心电图及心脏彩超检查,观察上述指标在评估急性肺栓塞预后中的意义.结果 (1)心电图评估急性肺栓塞预后中没有重要的意义.(2)超声心动图示舒张末期右室内径增大是肺栓塞出现严重并发症或死亡的危险因素,未发现肺动脉压是影响肺栓塞预后的指标.(3)cTnT阳性与cTnT阴性患者出现右心功能障碍、大面积肺栓塞、严重并发症均存在显著差异,Logistic回归分析发现肌钙蛋白阳性是肺栓塞出现严重并发症的危险因素.结论 右心功能是反映急性肺栓塞预后的重要指标,心脏彩超可以通过监测右心功能来反映急性肺栓塞的预后;心肌肌钙蛋白T与右心功能相关,也可评估急性肺栓塞的预后;心电图在反应右心功能上特异性差,评估急性肺栓塞的预后意义不大.
目的 探討心肌肌鈣蛋白T(cTnT)和心髒綵超在評估急性肺栓塞預後中的意義,以便及時準確地製定肺栓塞的治療方案,改善患者的預後.方法 本研究的對象為廣州呼吸疾病研究所105例已確診為肺栓塞的病人,所有病人在入院24h內行心肌肌鈣蛋白T(cTnT),心電圖及心髒綵超檢查,觀察上述指標在評估急性肺栓塞預後中的意義.結果 (1)心電圖評估急性肺栓塞預後中沒有重要的意義.(2)超聲心動圖示舒張末期右室內徑增大是肺栓塞齣現嚴重併髮癥或死亡的危險因素,未髮現肺動脈壓是影響肺栓塞預後的指標.(3)cTnT暘性與cTnT陰性患者齣現右心功能障礙、大麵積肺栓塞、嚴重併髮癥均存在顯著差異,Logistic迴歸分析髮現肌鈣蛋白暘性是肺栓塞齣現嚴重併髮癥的危險因素.結論 右心功能是反映急性肺栓塞預後的重要指標,心髒綵超可以通過鑑測右心功能來反映急性肺栓塞的預後;心肌肌鈣蛋白T與右心功能相關,也可評估急性肺栓塞的預後;心電圖在反應右心功能上特異性差,評估急性肺栓塞的預後意義不大.
목적 탐토심기기개단백T(cTnT)화심장채초재평고급성폐전새예후중적의의,이편급시준학지제정폐전새적치료방안,개선환자적예후.방법 본연구적대상위엄주호흡질병연구소105례이학진위폐전새적병인,소유병인재입원24h내행심기기개단백T(cTnT),심전도급심장채초검사,관찰상술지표재평고급성폐전새예후중적의의.결과 (1)심전도평고급성폐전새예후중몰유중요적의의.(2)초성심동도시서장말기우실내경증대시폐전새출현엄중병발증혹사망적위험인소,미발현폐동맥압시영향폐전새예후적지표.(3)cTnT양성여cTnT음성환자출현우심공능장애、대면적폐전새、엄중병발증균존재현저차이,Logistic회귀분석발현기개단백양성시폐전새출현엄중병발증적위험인소.결론 우심공능시반영급성폐전새예후적중요지표,심장채초가이통과감측우심공능래반영급성폐전새적예후;심기기개단백T여우심공능상관,야가평고급성폐전새적예후;심전도재반응우심공능상특이성차,평고급성폐전새적예후의의불대.
Objective Prognostic value of cardiac troponin T,echocardiography and ECG in patients with confirmed pulmonary embolism were evaluated. Methods 105 consecutive patients with confirmed PE were enrolled in this retrospective study. PE was confirmed by pulmonary angiography,lung scan or echocardiography and subsidiary analyses, cTnT was measured within 24 hours after admission. ECG and ECHO were recorded within 24 hours after admission. Results ECG signs of acute right ventricular strain are not predictors of mortality and severe complications in patients with confirmed PE. Only right ventricular dilation but not pulmonary hypertension detected at echocardiography in patients with acute PE is an independent risk factor for fatal outcome. There were significant differences in right ventricular dysfunction,massive PE and severe complications between the troponin-positive group and the troponin-negative group. In logistic regression analysis,cTnT is an independent predictor of severe complications. Furthermore,high cTnT was significantly associated with severe PE. Conclusion Right ventricular function is an important prognostic factor for pulmonary embolism. Echocardiographically detected right ventricular dysfunction can be used to assess the prognosis of PE. Elevation of cTnT was significantly associated with right ventricular dysfunction,and can be used to assess the prognosis of PE. ECG signs of acute right ventricular strain were not specific, so can not be used to assess the prognosis of PE.
