血浆脑钠肽浓度在急性肺栓塞治疗中的指导作用.docVIP

精品论文 参考文献 血浆脑钠肽浓度在急性肺栓塞治疗中的指导作用 钟伟济 冯起校 于斌 李志波 （广东省中山市陈星海医院内科 528415） 【摘要】目的 通过对急性肺栓塞治疗前后脑钠肽的分析对比，了解脑钠肽（BNP）水平与急性肺栓塞分型的相关性及对预后的评估。方法 根据临床表现把32例急性肺栓塞（APE）患者分为3组：大面积型（A组，6例）、次大面积型（B组，21例）及非大面积型（C组，5例），其中B组又分为溶栓亚组（B1组，10例）及非溶栓亚组（B2组，11例），对A组、B1组均予溶栓治疗及其他常规治疗；对B2组、C组予常规治疗，所有病例监测右心功能、血气分析、D-二聚体（DD）、脑钠肽、血压及出院后随访。结果 血浆BNP浓度：A组（768plusmn;354pg/ml），B组（575plusmn;436pg/ml），C组（68plusmn;42pg/ml）。A组死亡5例，B2组4例死亡，B2组其中1例死亡病例是在3个月的随访期中与肺栓塞相关死亡，B1组、C组无死亡；存活病例治疗后BNP比治疗前均明显降低（Plt;0.01）。结论 血浆BNP浓度与APE各分型、疗效呈一定相关性，通过治疗前后BNP的浓度对比变化，对APE的预后也可作出评估，因此，检测血浆脑钠肽浓度在急性肺栓塞治疗中有着重要的指导作用。 【关键词】 脑钠肽 急性肺栓塞 分型 预后 相关性 【中图分类号】R563.5【文献标识码】A【文章编号】2095-1752（2012）29-0128-02 The guiding role of plasma brain natriuretic peptide In treatment of acute puImonary embolism Zhong Weiji,Feng Qixiao,Yu Bin,Li Zhibo (Department of internal medicine, Chen Xinghai Hospital of Zhongshan,Guangdong,China,528415) 【Abstract】 Objective To anaIyze the level of brain natriuretic peptide(BNP) in treatment of acute puImonary embolism(APE), Grasp the relationship between the level of BNP and typing of APE evaluate the prognosis. Method：A total of 32 patients with confirmed APE were divided into three groups，according to the clinical manifestations:massive pulmonary embolism(group A,n=6), submassive pulmonary embolism(group B,n=21),non- massive pulmonary embolism(group C,n=5), Group B were divided into thrombolytic subgroup(group B1,n=10) and non-thrombolytic subgroup(group B2,n=11), group A and group B1 received thrombolytic and conventional treatment, group B2 and group C received conventional treatment,and monitor the right ventricular function and arterial blood gas were analysed and D-dimer and brain natriuretic peptide and blood pressure and discharged from hospital follow-up. Results: plasma BNP: group A（768plusmn;354pg/ml）, group B（575plusmn;436pg/ml）,group C（68plusmn;42pg/ml）. 5 patients died in group A,and 4 patients died in group B2,No patients died in group B1 and C. plasma BNP