心肌标志物预测动脉瘤性蛛网膜下腔出血导致的神经源性肺水肿价值

摘要

目的 动脉瘤性蛛网膜下腔出血患者心肌标志物水平与发生神经源性肺水肿(NPE)的相关性研究.方法 2014年6月至2017年6月住院的207例急性动脉瘤性蛛网膜下腔出血患者进行回顾性分析,将患者入院时及发生NPE时的临床表现、心电图、心肌标志物等进行测量,分析数据以预测神经源性肺水肿的发生.结果 15例(7.25％)患者发生了NPE,组间对照研究发现女性、高血压、糖尿病的患者更容易发生NPE,发生NPE的患者更容易有心肌损伤和心电图的改变,肌红蛋白、肌钙蛋白、肌酸磷酸激酶(CPK)及其同工酶(CPK-MB)均有明显异常(P<0.01).结论 发生NPE的蛛网膜下腔出血的患者心肌标志物明显增高,心电图波形有明显异常,升高的心肌酶标志物可以预测NPE的发生.%Objective To investigate the correlation between the levels of myocardial biomarkers and incidence of neurogenic pulmonary edema ( NPE) in patients with aneurysmal subarachnoid hemorrhage ( SAH) . Methods A total of 207 patients with SAH who were admitted and treated in our hospital from June 2014 to June 2017 were enrolled in the study. The clinical data including clinical characteristics,electrocardiogram ( ECG) changes,and serum levels of cardiac and inflammatory biomarkers on admission and on the day of occurrence of NPE,were retrospectively analyzed to predict the occurrence of NPE. Results Among 207 patients, 15 patients (7. 25％) developed NPE. The female patients and the patients with hypertension or diabetes mellitus were more likely to suffer from NPE. Moreover the patients with NPE were more likely to occur myocardial damage and ECG changes,with obvious abnormalities of myohemoglobin, troponin, CPK and CPK-MB (P < 0. 01). Conclusion The myocardial biomarkers are obviously increased in patients with SAH complicated by NPE, with obvious abnormalities of ECG,therefor, the increase of myocardial biomarkers can predict the occurrence of NPE.