中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2012年
6期
638-641
,共4页
张志忠%王国兴%谢苗荣%杨立沛
張誌忠%王國興%謝苗榮%楊立沛
장지충%왕국흥%사묘영%양립패
急性肺栓塞%B型尿钠肽%肌钙蛋白Ⅰ%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
急性肺栓塞%B型尿鈉肽%肌鈣蛋白Ⅰ%纖維蛋白降解產物%D-二聚體%C反應蛋白%右心室功能%評估%預後
급성폐전새%B형뇨납태%기개단백Ⅰ%섬유단백강해산물%D-이취체%C반응단백%우심실공능%평고%예후
Acute pulmonary embolism%Brain natriaretie peptide%Troponin Ⅰ%Fibrin degredation product%D-Dimer%C-reactive protein%Right ventricular function%Assessment%Prognosis
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-RA PG(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/ml vs. (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-RA PG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.
目的 探討BNP(B型尿鈉肽)在急性肺栓塞早期病情評估中的意義.方法 選擇2005年11月至2010年6月北京友誼醫院資料完全的急性肺栓塞病例86例進行迴顧性分析,根據有無右心功能障礙分為兩組,比較兩組間BNP等相關指標間的差異,併行BNP與RV-RA PG(右心房和右心室的壓力梯度值)之間的相關性分析；根據有無併髮癥分為兩組,比較兩組間BNP等相關指標間的差異.結果 (1)右心功能障礙與右心功能正常的患者,組間比較採用兩組間配對t檢驗,兩組BNP分彆為(320.4±190.5) pg/ml vs. (51.5±30.79)pg/ml,P＜0.05,差異具有統計學意義.(2) BNP與右心功能RV-RA PG行線性相關分析,兩組間有較好的相關性(r=0.824,P＜0.01); (3) BNP預測右心功能障礙ROC麯線分析,ROC麯線下麵積(AUC值)0.907,錶明BNP能較好預測右心功能障礙情況；(4)有併髮癥的患者與無併髮癥的患者,組間比較採用兩組間配對t檢驗,兩組間BNP分彆為(1356.8±675.4) pg/ml vs.(103.8±51.4) pg/ml,P＜0.05,差異具有統計學意義；兩組間pH分彆(7.372±3.7)vs.(7.446±3.5),P＜0.05,差異具有統計學意義.結論 (1) BNP在急性肺栓塞患者的早期診療中,對預測患者右心衰的髮生及病情的嚴重程度和預後有著積極的臨床意義(2)早期的動脈血氣pH值在急性肺栓塞患者的早期診療中,對預測病情的嚴重程度和預後有著積極的參攷價值.
목적 탐토BNP(B형뇨납태)재급성폐전새조기병정평고중적의의.방법 선택2005년11월지2010년6월북경우의의원자료완전적급성폐전새병례86례진행회고성분석,근거유무우심공능장애분위량조,비교량조간BNP등상관지표간적차이,병행BNP여RV-RA PG(우심방화우심실적압력제도치)지간적상관성분석；근거유무병발증분위량조,비교량조간BNP등상관지표간적차이.결과 (1)우심공능장애여우심공능정상적환자,조간비교채용량조간배대t검험,량조BNP분별위(320.4±190.5) pg/ml vs. (51.5±30.79)pg/ml,P＜0.05,차이구유통계학의의.(2) BNP여우심공능RV-RA PG행선성상관분석,량조간유교호적상관성(r=0.824,P＜0.01); (3) BNP예측우심공능장애ROC곡선분석,ROC곡선하면적(AUC치)0.907,표명BNP능교호예측우심공능장애정황；(4)유병발증적환자여무병발증적환자,조간비교채용량조간배대t검험,량조간BNP분별위(1356.8±675.4) pg/ml vs.(103.8±51.4) pg/ml,P＜0.05,차이구유통계학의의；량조간pH분별(7.372±3.7)vs.(7.446±3.5),P＜0.05,차이구유통계학의의.결론 (1) BNP재급성폐전새환자적조기진료중,대예측환자우심쇠적발생급병정적엄중정도화예후유착적겁적림상의의(2)조기적동맥혈기pH치재급성폐전새환자적조기진료중,대예측병정적엄중정도화예후유착적겁적삼고개치.
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 right 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 dysfunction 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 (γ =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.
