血浆氨基末端脑钠肽前体检测对急性肺栓塞患者右心衰竭诊断的意义

目的探讨血浆氨基末端脑钠肽前体(NT-proBNP)水平对急性肺栓塞(APE)所致右心衰竭的诊断价值以及对预后判断的意义。方法 31例APE患者分为3组:大面积栓塞组(9例),次大面积栓塞组(15例),小面积栓塞组(7例)。所有患者均测量血压、血肌酐、D-二聚体及NT-proBNP水平,并行心脏及双下肢静脉血管彩色多普勒超声检查,观察患者临床表现和预后情况。结果大面积栓塞组D-二聚体、NT-proBNP水平及右心室/左心室舒张末内径比值均明显高于次大面积栓塞组,而小面积栓塞组上述指标明显低于次大面积栓塞组,差异均具有统计学意义(P均0.05)。结论 APE患者右心室功能障碍与NT-proBNP水平明显相关。检测NT-proBNP水平有助于评价APE患者危险分层。

Value of N-terminal pro-brain natriuretic peptide in patients with right heart failure induced by ower acute pulmonary embolism

Objective To examine the value of N-terminal pro-brain natriuretic peptide（NT-proBNP） in patients with right heart failure induced by acute pulmonary embolism（APE） . Methods A total of 31 patients with APE were divided into three groups：massive APE group（9 cases） ,sub-massive APE group（15 cases） ,and non-massive APE group（7 cases） . The levels of D-dimer and plasma NT-proBNP were measured and echocardiography was performed in all patients. Results The levels of D-dimer and plasma NT-proBNP and right/left ventricular end-diastolic diameter ratio were higher in the massive APE group than the submassive APE group,while these in the non-massive APE group were lower than the sub-massive APE group（all P0.05） . Conclusions Plasma NT-proBNP level correlated to the degree of right ventricular dysfunction. Detecting NT-proBNP may help to define risk grade and guide treatment.