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目的探讨中危肺栓塞患者超声心动图、心脏生物标志物、肺栓塞指数(PAOI)、血气分析等指标与预后的关系。方法收集该院2011年6月—2014年12月中危肺栓塞患者98例,根据3个月内是否出现不良事件分为二组:出现不良事件归为B组,病情逐渐好转稳定归为A组,比较二组超声心动图,四腔心切面中右心室与左心室的舒张末期内径之比(RV/LV),脑钠肽前体(NT-proBNP),肌钙蛋白(cTnI),氧分压(PaO2),肺动脉阻塞指(PAOI)。结果 A组69例,B组29例,B组NT-proBNP、cTnI、RV/LV二项以上阳性例数25例(86.2%),A组24(34.8%)二组差异有统计学意义。B组中三项均阳性的16例(55.2%),A组中三项均阳性的5例(0.7%),二组差异有统计学意义(P<0.05)。B组NT-proBNP,cTnI,RV/LV高于A组,P<0.05。B组PaO2低于A组,P<0.05。B组PAOI高于A组,但差异无统计学意义(P>0.05)。结论超声心动图、心脏生化标志物、PaO2,影响肺栓塞患者预后。通过联合应用多种方法,尽早预知哪些中危患者可能发生不良事件,指导确立更合适的治疗方案,降低不良事件的发生,降低死亡率。
Objective To investigate the relationship between echocardiography, cardiac biomarkers, pulmonary embolism index (PAOI), blood gas analysis and prognosis in patients with moderate-risk pulmonary embolism. Methods A total of 98 patients with moderate-risk pulmonary embolism in our hospital from June 2011 to December 2014 were enrolled and divided into two groups according to whether there were adverse events within 3 months: The adverse events were classified as group B, and the disease gradually improved and stabilized as A (RV / LV), NT-proBNP, cTnI, oxygen in the four chamber echocardiography were compared between the two groups. Partial pressure (PaO2), pulmonary artery obstruction refers to (PAOI). Results A group of 69 cases, B group of 29 cases, B group NT-proBNP, cTnI, RV / LV more than two positive cases in 25 cases (86.2%), A group 24 (34.8%) two groups difference was statistically significant. In group B, 16 cases (55.2%) were positive in all three cases and 5 cases (0.7%) in group A were all positive. The difference between the two groups was statistically significant (P <0.05). NT-proBNP, cTnI and RV / LV in group B were higher than those in group A (P <0.05). PaO2 in group B was lower than that in group A, P <0.05. PAOI in group B was higher than that in group A, but the difference was not statistically significant (P> 0.05). Conclusion Echocardiography, cardiac biochemical markers, PaO2, affect the prognosis of patients with pulmonary embolism. Through the combined use of a variety of methods, as early as possible to predict which intermediate-risk patients may occur adverse events, and guide the establishment of a more appropriate treatment, reduce the incidence of adverse events, reduce mortality.