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目的:探讨NT-proBNP测定在急性肺血栓栓塞症溶栓治疗中的意义。方法:将62例血流动力学稳定的次大面积肺血栓栓塞症患者分为溶栓组与非溶栓组,比较两组间治疗前后临床表现、生命体征及预后的差异,并进一步以外周血NTproBNP是否增高分组,比较组间上述统计指标的差异。结果 :溶栓组与非溶栓组相比,治疗前后心率、收缩压、呼吸频率、DDimer、PaO2变化的差异不明显,胸闷症状改善率及临床不良事件发生率两组间无显著差别。NT-proBNP增高的患者溶栓组心率、收缩压、呼吸频率、D-Dimer、PaO2的改善显著优于非溶栓组,胸闷改善率及临床不良事件率均优于非溶栓组;NT-proBNP正常的患者溶栓组与非溶栓组相比,上述指标差异不明显。非溶栓治疗的患者中,NT-proBNP正常的患者心率、收缩压、PaO2的改善优于NT-proBNP增高的患者,不良事件发生率显著低于NT-proBNP增高的患者;而溶栓治疗的患者,NT-proBNP增高组与NT-proBNP正常组上述指标无显著差异。结论:溶栓治疗可以改善NT-proBNP增高的次大面积肺栓塞患者的预后,但对NTproBNP正常的患者预后改善不明显。
Objective: To investigate the significance of NT-proBNP in thrombolytic therapy of acute pulmonary thromboembolism. Methods: Sixty-two patients with sub-maximal pulmonary thromboembolism with hemodynamic stability were divided into thrombolysis group and non-thrombolysis group. The clinical manifestations, vital signs and prognosis were compared between the two groups before and after treatment. Blood NTproBNP increased group, comparing the difference between the above statistical indicators. Results: There were no significant differences in heart rate, systolic blood pressure, respiration rate, DDimer and PaO_2 before and after thrombolytic therapy compared with those without thrombolysis. There was no significant difference between the two groups in the improvement rate of chest pain and the incidence of adverse clinical events. NT-proBNP increased thrombolysis in patients with thrombolysis heart rate, systolic blood pressure, respiratory rate, D-Dimer, PaO2 improved significantly better than the non-thrombolytic group, improve the rate of chest tightness and clinical adverse events were better than non-thrombolytic group; NT- Patients with normal proBNP thrombolytic group compared with non-thrombolytic group, the above indicators were not significantly different. Among patients without thrombolytic therapy, patients with normal NT-proBNP had better heart rate, systolic blood pressure, and PaO 2 than those with NT-proBNP, and had a significantly lower incidence of adverse events than patients with NT-proBNP. Patients treated with thrombolytic therapy Patients, NT-proBNP increased group and NT-proBNP normal group of the above indicators no significant difference. Conclusion: Thrombolytic therapy can improve the prognosis of patients with sub-maxillary pulmonary embolism with NT-proBNP elevation, but the prognosis of patients with normal NTproBNP is not obvious.