CAJ | 학술논문

目的：探讨血浆肌钙蛋白、B型钠尿肽及D-二聚体在急性肺栓塞临床诊断中的价值。方法随机选取住院治疗的116例急性肺栓塞患者，根据患者病情分为高危组58例和低危组58例。采用ELISA法检测2组患者的血浆肌钙蛋白、B型钠尿肽及D-二聚体水平并进行分析。结果高危组的血浆肌钙蛋白和B型钠尿肽水平明显高于低危组，差异有统计学意义（P＜0．05），2组D-二聚体水平差异无统计学意义（ P＞0．05）。血浆肌钙蛋白（61．21％）、B型钠尿肽（74．14％）的阳性率明显高于D-二聚体（36．21％），差异有统计学意义（ P＜0．05）。D-二聚体对急性肺栓塞检测的灵敏度为81．4％，特异度为86．7％；血浆肌钙蛋白的灵敏度为95．6％，特异度为86．7％；B型钠尿肽的灵敏度为97．1％，特异度为95．9％；血浆肌钙蛋白、B型钠尿肽的灵敏度和特异度明显高于D-二聚体，差异有统计学意义（P＜0．05）。结论血浆肌钙蛋白、B型钠尿肽及D-二聚体对于急性肺栓塞的临床诊断均具有一定意义，但是血浆肌钙蛋白、B型钠尿肽比D-二聚体具有更好的灵敏度和特异度。
목적：탐토혈장기개단백、B형납뇨태급D-이취체재급성폐전새림상진단중적개치。방법수궤선취주원치료적116례급성폐전새환자，근거환자병정분위고위조58례화저위조58례。채용ELISA법검측2조환자적혈장기개단백、B형납뇨태급D-이취체수평병진행분석。결과고위조적혈장기개단백화B형납뇨태수평명현고우저위조，차이유통계학의의（P＜0．05），2조D-이취체수평차이무통계학의의（ P＞0．05）。혈장기개단백（61．21％）、B형납뇨태（74．14％）적양성솔명현고우D-이취체（36．21％），차이유통계학의의（ P＜0．05）。D-이취체대급성폐전새검측적령민도위81．4％，특이도위86．7％；혈장기개단백적령민도위95．6％，특이도위86．7％；B형납뇨태적령민도위97．1％，특이도위95．9％；혈장기개단백、B형납뇨태적령민도화특이도명현고우D-이취체，차이유통계학의의（P＜0．05）。결론혈장기개단백、B형납뇨태급D-이취체대우급성폐전새적림상진단균구유일정의의，단시혈장기개단백、B형납뇨태비D-이취체구유경호적령민도화특이도。
Objective To investigate the value of plasma troponin ,B-type natriuretic peptide and D-dimer in the clinical diagnosis of acute pulmonary embolism .Methods A total of 116 patients with acute pulmonary embolism were randomly selected and divided into high-risk group and low-risk group according to the patient′s condition ,58 patients in each group .Enzyme-linked immunosor-bent assay was used to detected levels of plasma troponin ,B-type natriuretic peptide and D-dimer .Results The plasma troponin and B-type natriuretic peptide levels in the high-risk group were significant higher than those of the low-risk group(P<0 .05) ,but there was no significant difference on D-dimer level(P>0 .05) .The positive rate of plasma troponin(61 .21% )and B-type natriuretic pep-tide(74 .14% )were significant higher than that of D-dimer(36 .21% ) ,the differences were significant(P<0 .05) .The sensitivity of D-dimer was 81 .4 % ,specificity was 86 .7% .The sensitivity of plasma troponin was 95 .6% ,the specificity was 86 .7% .The sensi-tivity of B-type natriuretic peptide was 97 .1% ,the specificity was 95 .9% .The sensitivity and specificity of plasma troponin and B-type natriuretic peptide were significant higher than D-dimer(P<0 .05) .Conclusion Plasma troponin ,B-type natriuretic peptide and D-dimer have certain implications for the clinical diagnosis of acute pulmonary embolism ,but plasma troponin ,B-type natriuretic peptide has better sensitivity and specificity compared with D-dimer .