NT-proBNP测定在次大面积肺栓塞溶栓治疗中的意义

发布时间：2018-12-09 17:42

【摘要】：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。
[Abstract]:Objective: to investigate the significance of NT-proBNP in thrombolytic therapy of acute pulmonary thromboembolism. Methods: Sixty-two patients with submassive pulmonary thromboembolism with stable hemodynamics were divided into thrombolytic group and non-thrombolytic group. The clinical manifestations, vital signs and prognosis of the two groups were compared before and after treatment. Furthermore, the NTproBNP in peripheral blood was divided into two groups, and the difference of the above statistical indexes was compared between the two groups. Results: there was no significant difference in heart rate, systolic blood pressure, respiratory frequency and DDimer,PaO2 between thrombolytic group and non-thrombolytic group before and after treatment. The improvement of heart rate, systolic blood pressure, respiratory frequency and D-Dimer Pao _ 2 in patients with increased NT-proBNP were significantly better than those in non-thrombolytic group, but there was no significant difference between the two groups in the improvement rate of chest tightness and the incidence of clinical adverse events. The improvement rate of chest tightness and the rate of clinical adverse events were better than those of non-thrombolytic group. There was no significant difference between the thrombolytic group and non-thrombolytic group in patients with normal NT-proBNP. In non-thrombolytic therapy, the improvement of heart rate, systolic blood pressure and PaO2 in patients with normal NT-proBNP was better than that in patients with increased NT-proBNP, and the incidence of adverse events was significantly lower than that in patients with increased NT-proBNP. In thrombolytic therapy, there was no significant difference between NT-proBNP elevation group and normal NT-proBNP group. Conclusion: thrombolytic therapy can improve the prognosis of patients with submassive pulmonary embolism with increased NT-proBNP, but the prognosis of patients with normal NTproBNP is not improved significantly.
【作者单位】：南京医科大学第一附属医院急诊科;
【基金】：江苏省人民医院新技术项目(2011)
【分类号】：R563.5

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