CAJ | 학술논문

目的：探讨氨基末端B型脑钠肽前体(NT-proBNP)对急性肺栓塞(APE)患者危险分层和预后预测的价值。方法回顾性分析2010年8月~2014年8月武汉市中心医院收治的APE患者102例。按危险分层分为高危组(24例)、中危组(49例)和低危组(29例)，记录各组基线资料并对相关指标进行比较；根据有无右心功能不全分为右心功能不全组和右心功能正常组，比较两组间NT-proBNP等相关指标间的差异；根据有无主要不良事件发生分为预后不良组和预后良好组，并对NT-proBNP等指标进行统计学分析。结果高危组、中危组、低危组三组患者入院时的心率、收缩压、右心功能不全的比例、指氧饱和度、动脉血氧分压(PaO2)、NT-proBNP、超敏肌钙蛋白Ⅰ(cTnⅠ)、D-二聚体(D-Dimer)的差异有统计学意义(P<0.05)；右心功能不全组患者的NT-proBNP值为(3224.6±284.6)ng/L，高于右心功能正常组患者的NT-proBNP值[(186.3±64.3)ng/L]，差异有统计学意义(P<0.05)；预后不良组的NT-proBNP水平明显高于预后良好组，差异有统计学意义(P<0.05)。结论 NT-proBNP检测有助于APE的危险分层，并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。
목적：탐토안기말단B형뇌납태전체(NT-proBNP)대급성폐전새(APE)환자위험분층화예후예측적개치。방법회고성분석2010년8월~2014년8월무한시중심의원수치적APE환자102례。안위험분층분위고위조(24례)、중위조(49례)화저위조(29례)，기록각조기선자료병대상관지표진행비교；근거유무우심공능불전분위우심공능불전조화우심공능정상조，비교량조간NT-proBNP등상관지표간적차이；근거유무주요불량사건발생분위예후불량조화예후량호조，병대NT-proBNP등지표진행통계학분석。결과고위조、중위조、저위조삼조환자입원시적심솔、수축압、우심공능불전적비례、지양포화도、동맥혈양분압(PaO2)、NT-proBNP、초민기개단백Ⅰ(cTnⅠ)、D-이취체(D-Dimer)적차이유통계학의의(P<0.05)；우심공능불전조환자적NT-proBNP치위(3224.6±284.6)ng/L，고우우심공능정상조환자적NT-proBNP치[(186.3±64.3)ng/L]，차이유통계학의의(P<0.05)；예후불량조적NT-proBNP수평명현고우예후량호조，차이유통계학의의(P<0.05)。결론 NT-proBNP검측유조우APE적위험분층，병대예측환자우심쇠적발생급병정적엄중정도화예후유착적겁적림상의의。
Objective To explore the value of NT-proBNP in the risk stratification and prognosis of patients with acute pulmonary embolism (APE). Methods One hundred and two cases of patients with APE admitted to the Central Hospi-tal of Wuhan from August 2010 to August 2014 were analyzed retrospectively. They were divided into three groups:high risk group (24 cases), moderate risk group (49 cases) and low risk group (29 cases) according to risk stratification, the baseline information was recorded and related indexes were recorded among the three groups; according to where there was right ventricular dysfunction, they were divided into right ventricular dysfunction group and normal right ven-tricular function group, the differences of NT-proBNP and other clinical indexes were compared between the two groups;according to whether there were occurrence of main adverse events, they were divided into poor prognosis group and favorable prognosis group, the NT-proBNP and other clinical indexes were analyzed statistically. Results The dif-ferences of heart rate, systolic blood pressure, the percentage of right ventricular dysfunction, finger oxygen saturation, PaO2 level, NT-proBNP, cTnⅠ and D-Dimer level were statistically significant among the three groups of high risk group, mode rate risk group, low risk group (P< 0.05). The plasma NT-proBNP level of right ventricular dysfunction group was (3224.6±284.6) ng/L, which was higher than that of normal right ventricular function group [(186.3±64.3) ng/L], and the difference was statistically significant (P< 0.05). The NT-proBNP level of favorable prognosis group was higher than that of poor prognosis group, the difference was statistically significant (P<0.05). Conclusion The detec-tion of NT-proBNP is helpful for the risk stratification of APE, and it has positive clinical significance for prediction of right heart failure, the severity of illness and prognosis.