血浆肌钙蛋白I、脑钠肽联合D-二聚体检查对肺血栓栓塞的临床意义

目的 研究联合应用脑钠肽（BNP）、心肌肌钙蛋白I（cTnI）和D-二聚体（DD）检查在血压正常的肺血栓栓塞（PTE）患者中的临床意义.方法 回顾性分析47例经肺通气/灌注扫描和（或）肺动脉CT成像（CTPA）明确诊断的非大面积肺血栓栓塞病例,以超声心动检查结果将其分为A组（次大面积PTE组）21例和B组（非大面积PTE组）26例,通过其血浆中的cTnI、BNP和DD的水平高低进行分析和评价.结果 血浆D-二聚体水平在A、B组间差异无统计学意义;BNP和cTnI血浆水平在A、B组间差异有统计学意义（P〈0.05）.结论 D-二聚体检查有助于排除诊断,血浆cTnI、BNP水平在次大面积PTE患者中明显升高,联合应用血浆cTnI、BNP和D-二聚体检查在血压正常的PTE患者中有助于筛选出高危患者.

Clinical Significance of Brain Natriuretic Peptide Combined with Cardiac Troponin I and D-dimer in Pulmonary thromboembolism

Objective To study the clinical significance of the combined use of serum cardiac troponin I（cTnI）,brain natriuretic peptide（BNP）and D-dimer in patients with pulmonary thromboembolism（PTE）. Methods Retrospective analysis was 47 cases of non-massive PTE diagnosed by pulmonary ventilation/perfusion scan and（or） CT pulmonary angiography（CTPA） in the hospital.Based on ultrasonic cardiogram results,all cases were divided into group A（submassive PTE group） and group B（non-massive PTE group）,to compare,analyze and evaluate typical signs of PTE shown by cTnI,BNP and D-dimer levels. Results There was no significant difference between the extent of D-dimer increase and the severity of PTE in group A and group B.cTnI and BNP had significant difference between group A and group B. Conclusion It is a good method to combine serum cTnI,BNP and D-dimer to screen high-risk patients among pulmonary thromboembolism patients with normal blood pressure.