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目的探讨血浆脑钠肽(BNP)水平在急性肺栓塞(APE)的变化及其意义。方法46例经肺螺旋CT确诊为APE患者,分为右心室功能不全组和无右心室功能不全组,测定血浆BNP后比较两组差异和观察比较两组患者临床表现、病死率等相关指标。结果右心室功能不全组BNP水平明显高于无右心室功能不全组(267 pg/ml±48pg/ml对62 pg/ml±31 pg/ml,P<0.05);前者严重临床表现:晕厥、低血压或休克高于后者(P<0.05);前者右心室功能指标:肺主动脉内径和压力、右心室内径、右心室活动度与后者比较,差异也有统计学意义(P均<0.05);前者病死率高于后者。结论BNP水平对判断APE时右心室功能有一定价值,从而可以帮助对APE患者危险分层及预后判断。
Objective To investigate the changes of plasma brain natriuretic peptide (BNP) level in patients with acute pulmonary embolism (APE) and its significance. Methods Forty-six patients with APE were diagnosed as APE by spiral CT. The patients were divided into right ventricular dysfunction group and non-right ventricular dysfunction group. The plasma BNP levels were measured and compared between the two groups. The clinical manifestations and mortality were compared between the two groups. Results The BNP level in patients with right ventricular dysfunction was significantly higher than that in patients without right ventricular dysfunction (267 pg / ml ± 48 pg / ml vs 62 pg / ml ± 31 pg / ml, P <0.05) Blood pressure or shock was higher than the latter (P <0.05); the former right ventricular function index: the diameter and pressure of the pulmonary aorta, right ventricular diameter and right ventricular activity compared with the latter, the difference was also statistically significant (P all <0.05) ; The former mortality is higher than the latter. Conclusion The level of BNP has some value in judging the right ventricular function during APE, which can help the risk stratification and prognosis of patients with APE.