论文部分内容阅读
目的探讨心肌肌钙蛋白T(cTnT)和心脏彩超在评估急性肺栓塞预后中的意义,以便及时准确地制定肺栓塞的治疗方案,改善患者的预后。方法本研究的对象为广州呼吸疾病研究所105例已确诊为肺栓塞的病人,所有病人在入院24h内行心肌肌钙蛋白T(cTnT),心电图及心脏彩超检查,观察上述指标在评估急性肺栓塞预后中的意义。结果(1)心电图评估急性肺栓塞预后中没有重要的意义。(2)超声心动图示舒张末期右室内径增大是肺栓塞出现严重并发症或死亡的危险因素,未发现肺动脉压是影响肺栓塞预后的指标。(3)cTnT阳性与cTnT阴性患者出现右心功能障碍、大面积肺栓塞、严重并发症均存在显著差异,Logistic回归分析发现肌钙蛋白阳性是肺栓塞出现严重并发症的危险因素。结论右心功能是反映急性肺栓塞预后的重要指标,心脏彩超可以通过监测右心功能来反映急性肺栓塞的预后;心肌肌钙蛋白T与右心功能相关,也可评估急性肺栓塞的预后;心电图在反应右心功能上特异性差,评估急性肺栓塞的预后意义不大。
Objective To investigate the significance of cardiac troponin T (cTnT) and echocardiography in the assessment of the prognosis of acute pulmonary embolism in order to make timely and accurate treatment of pulmonary embolism and improve the prognosis of patients. Methods The object of this study was 105 patients with pulmonary embolism diagnosed by Guangzhou Institute of Respiratory Diseases. All patients underwent cardiac troponin T (cTnT), electrocardiogram and echocardiography within 24h of admission, and the above indexes were evaluated in evaluating acute pulmonary embolism The significance of prognosis. Results (1) ECG evaluation of acute pulmonary embolism in the prognosis of no significance. (2) Echocardiography showed that the increase of end-diastolic diameter of right ventricle was the risk factor of serious complication or death of pulmonary embolism. No pulmonary hypertension was found to be the index of prognosis of pulmonary embolism. (3) Logistic regression analysis showed that troponin-positive was a risk factor for serious complications of pulmonary embolism in cTnT-positive and cTnT-negative patients with right ventricular dysfunction, large-area pulmonary embolism, and serious complications. Conclusion Right heart function is an important index to reflect the prognosis of acute pulmonary embolism. Echocardiography can reflect the prognosis of acute pulmonary embolism by monitoring right heart function. Cardiac troponin T is associated with right heart function and prognosis of acute pulmonary embolism. ECG in response to right heart function is poor specificity, prognosis of acute pulmonary embolism is of little significance.