B型尿钠肽、肌钙蛋白I、同型半胱氨酸与急性肺栓塞的相关性分析

摘要

目的 探讨B型尿钠肽、肌钙蛋白I、同型半胱氨酸与急性肺栓塞的相关性.方法 选取2015年5月至2017年5月期间,我院收治的104例急性肺栓塞(APE)患者作为研究对象,选取同期健康体检者100例作为对照组.比较急性肺栓塞组与健康体检者以及大面积肺栓塞患者与非大面积肺栓塞患者、死亡与存活患者血清BNP、TnI及Hcy水平以及三项指标对急性肺栓塞的诊断价值.结果 急性肺栓塞组患者血清BNP、TnI及Hcy水平显著高于健康对照组(P<0.05).大面积肺栓塞患者血清BNP、TnI及Hcy水平显著高于非大面积肺栓塞患者(P<0.05).急性肺栓塞死亡患者血清BNP、TnI及Hcy水平显著高于存活者(P<0.05).血清BNP+TnI+Hcy联合检测的灵敏度(86.7%)、特异性(90.9%)及准确度(88.5%)明显高于任一项指标的检测(P<0.05).Pearson相关性分析表明,BNP、TnI及Hcy是急性肺栓塞患者发生临床不良事件的独立危险因素,血清BNP与TnI及Hcy呈正相关关系.结论 血清BNP、TnI及Hcy联合检测可反映急性肺栓塞的病情严重程度,可作为预后评估的有效指标.%Objective To investigate the correlation between type B natriuretic peptide, troponin I, homocysteine and acute pulmonary embolism.Methods From May 2015 to May 2017,104 patients with APE were enrolled as the study objects in our hospital,while 100 healthy subjects were selected as control group at the same time.The serum BNP,TnI and Hcy levels in acute pulmonary embolism patients and healthy subjects,in large area pulmonary embolism patients and non-large pulmonary embolism patients,in death and survival patients,and the value of three indexes in the diagnosis of acute pulmonary embolism were compared.Results The serum levels of BNP,TnI and Hcy in the observation group were significantly higher than those in the healthy control group(P<0.05).The levels of serum BNP,TnI and Hcy in patients with large area pulmonary embolism were significantly higher than those in non-large area pulmonary embolism patients(P<0.05).Compared with patients died of acute pulmonary embolism,the serum BNP TnI and Hcy levels were significantly higher in survivors(P<0.05).The sensitivity(86.7%),the specificity(90.9%)and the accuracy(88.5%)of the combined detection of serum BNP,TnI and Hcy were significantly higher than those of either of the two indicators(P<0.05).After Pearson correlation analysis,BNP,TnI and Hcy were independent risk factors of clinical adverse events in patients with acute pulmonary embolism,and serum BNP was positively related to TnI and Hcy.Conclusion The combined detection of serum BNP,TnI and Hcy may reflect the severity of acute pulmonary embolism and can be used as an effective indicator for prognosis evaluation.