急性肺栓塞患者肌钙蛋白I的检测及临床意义

[目的]探讨急性肺栓塞（PE）患者血清肌钙蛋白I（cTnI） 水平与肺动脉压、右心功能及预后的关系.[方法]48例急性PE入院后行cTnI水平测定后,以cTnI＞0.1 ng/mL定义为肌钙蛋白升高,分为cTnI正常组（A组）22例与cTnI升高组（B组）26例,比较两组肺动脉压、右心室功能障碍、右室负荷过重发生率、病死率及不同栓塞面积情况.[结果]B组低血压、右室功能障碍、肺动脉压、右室负荷过重及病死率的发生率与A组比较差异有显著性（P〈0.05）; B组非大面积、次大面积及大面积肺栓塞患者与A组比较均有显著性差异（P〈0.05）;经Logistic逐步回归分析,肌钙蛋白升高是肺栓塞患者死亡的独立危险因素.[结论] cTnI可作为急性肺栓塞患者独立的预后指标,明确危险分层,指导治疗,并且和较差的预后相关.

Detection of Troponin I in Patients with Acute Pulmonary Embolism and Its Clinical Significance

[Objective] To investigate the relationship between the levels of troponin I（cTnI） and pulmonary artery pressure, right ventricular function and the prognosis in the patients with acute pulmonary embolism（PE）. [MethodslcTnI were measured in 48 patients with PE, and cTnI〉0, lng/mL was defined as the rising of cTnI. All patients were divided into the group with normal levels of cTnI（group A, n=22） and the group with elevated levels of cTnI（group B, n= 26）. The pulmonary artery pressure, right ventricular dysfunction, right ventricular overload, mortality rate and different areas of PE were compared between two groups. [ResultslThere were significant differences in the incidence of low blood pressure, right ventricular dysfunction, pulmonary artery pressure, right ventricular overload and mortality rate between group A and group B. And there were significant differences in massive PE, sub-massive PE and non-massive PE between group A and group B. Logistic regression analysis showed that the rising of cTnI was an independent risk fac tor of death in patients with PE. [ConclusionlcTnI can be used as the independent prognostic indicators in patients with acute PE, and is helpful for clearing the risk stratification and guiding the treatment, and it is correlated to the poor prognosis.