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中华肺部疾病杂志(电子版) ›› 2017, Vol. 10 ›› Issue (02) : 130 -132. doi: 10.3877/cma.j.issn.1674-6902.2017.02.003

所属专题: 文献

论著

肺栓塞危险因素和联合检测cTnT、BNP、CRP、D-二聚体的临床分析
房延凤1, 李王平1,(), 张红军1, 孙瑞琳1, 傅恩清1, 金发光1   
  1. 1. 710038 西安,第四军医大学唐都医院呼吸与危重症医学科
  • 收稿日期:2017-02-12 出版日期:2017-04-20
  • 通信作者: 李王平
  • 基金资助:
    军委高干保健科研基金项目(14BJ255)

Clinical analysis of risk factors for pulmonary embolism and joint detection of cTnT, BNP, CRP, D-dimer

Yanfeng Fang1, Wangping Li1,(), Hongjun Zhang1, Ruilin Sun1, Enqing Fu1, Faguang Jin1   

  1. 1. Department of Pulmonary and Critical Care Medicine, Tangdu Hospital, the Fourth Military Medical University, Xi′an, 710038, China
  • Received:2017-02-12 Published:2017-04-20
  • Corresponding author: Wangping Li
  • About author:
    Corresponding author: Li Wangping, Email:
引用本文:

房延凤, 李王平, 张红军, 孙瑞琳, 傅恩清, 金发光. 肺栓塞危险因素和联合检测cTnT、BNP、CRP、D-二聚体的临床分析[J/OL]. 中华肺部疾病杂志(电子版), 2017, 10(02): 130-132.

Yanfeng Fang, Wangping Li, Hongjun Zhang, Ruilin Sun, Enqing Fu, Faguang Jin. Clinical analysis of risk factors for pulmonary embolism and joint detection of cTnT, BNP, CRP, D-dimer[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2017, 10(02): 130-132.

目的

探讨肺栓塞危险因素及检测心肌肌钙蛋白T(cTnT)、脑钠肽(BNP)、C反应蛋白(CRP)、D-二聚体对其诊断及危险分层的意义。

方法

收集2014年8月至2016年7月第四年医大学唐都医院呼吸科住院的通过临床表现、辅助检查等确诊为急性肺栓塞患者103例,分为高危组、中危组、低危组,并对危险因素及异常指标进行回顾性分析。

结果

深静脉血栓形成是最重要的危险因素(46.6%),其次年龄>65岁(39.8%)、心血管疾病(26.2%)、肿瘤(22.3%)、外科手术(18.4%)、慢性肺部疾病(17.5%)、创伤与骨折(13.6%),再次是下肢静脉曲张或静脉炎(9.7%);检查异常指标中,三组D-二聚体升高的患者占96.117%,三组间无统计学差异(P=0.217),高危组、中危组中cTnT、BNP、CRP升高的例数均较低危组多,高危组也多于中危组,各组间相比有统计学差异(P<0.05)。

结论

深静脉血栓是肺栓塞最重要的危险因素,D-二聚体在肺栓塞中升高的敏感性最高,但也存在D-二聚体阴性的肺栓塞,D-二聚体、cTnT、BNP、CRP与其危险分层呈正相关。

Objective

To review the risk factors of pulmonary embolism and explore the combined detection of cardiac troponin T( cTnT), brain natriuretic peptide (BNP), C-reactive protein (CRP), D-dimer for diagnosis and risk stratification of the guiding significance.

Methods

All 103 patients with acute pulmonary embolism were collected by clinical manifestation and auxiliary examination confirmed from August 2014 to July 2016 in department of respiratory of Tangdu Hospital of Fourth Military Medical Unirersity and divided into high-risk group, the moderate-risk group, the low risk group, retrospectively analyzed the risk factors and abnormal index.

Results

The incidence of deep venous thrombosis was the most important risk factor in 46.6%, followed by age>65 years old 39.8%, cardiovascular disease 26.2%, tumor 22.3%, surgery 18.4%, chronic lung disease 17.5%, trauma and fracture 13.6%. Again, lower limb varicose veins or phlebitis 9.7%. The abnormal checking indicators: The patients of D-dimer increased accounted for 96.117% in three groups. There were no statistical difference between them(P=0.217). The number of elevated cTnT, BNP and CRP in high-risk group and moderate-risk group were higher than that in low-risk group, the high-risk group was also higher than moderate group, each group compared to statistically significant(P<0.05).

Conclusions

Deep vein thrombosis was the most important risk factors of pulmonary embolism. The sensitive of elevated D-dimer was the most in pulmonary embolism. There was D-dimer-negative pulmonary embolism and cTnT, BNP and CRP were positively correlated with risk stratification.

表1 危险因素构成比的分布[n(%)]
表2 各组中D-二聚体、BNP、cTnT及CRP升高比例比较[n(%)]
1
梁颖,米玉红,杨赓,等. 急性肺栓塞患者焦虑抑郁状态与肺栓塞严重程度分析[J/CD]. 中华肺部疾病杂志(电子版), 2016, 9(3): 297-300.
2
张挪富,周玉民,杨新艳,等. 不同年龄段肺血栓栓塞症患者的临床特征及预后影响因素分析[J]. 中华结核和呼吸杂志,2010, 33(6): 436-440.
3
Lyman GH, Khorana AA, Falanga A, et al. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophyla-xis and treatment in patients with cancer[J]. J Clin Oncol, 2007, 25(34): 5490-5505.
4
Zangari M, Fink LM, Elice F, et al. Thrombotic events in patients with cancer receiving antiangiogenesis agents[J]. J Clin Oncol, 2009, 27(29): 4865-4873.
5
Lee CH, Cheng CL, Kao Yang YH, et al. Hormone therapy and risk of venous htrom-boembolism among postmenopausal women in taiwan 10-year nationwide population-based study[J]. Circ J, 2015, 79(5): 1107-1114.
6
Maempel JF, Darmanin G, Naeem K, et al. Olanzapine and pulmonary embolism, a rare association: a case report[J]. Cases J, 2010, 22(3): 36.
7
Vandamme YM, Ducancelle A, Biere L, et al. My opericarditis complicated by pulmonary embolism in an immunocompetent patient with acute cytomegalovirus infection:a case report[J]. BMC Res Notes, 2014, 28(7): 193.
8
于丽娜,李琳,张劲松. 肌钙蛋白T和脑利钠肽对急性肺栓塞患者病情和预后评价的临床研究[J]. 南京医科大学学报,2012, 32(1): 82-85.
9
赵春菱,张剑锋. 心肌损伤标志物在急性肺栓塞中的应用[J]. 蛇志,2013, 25(2): 217-218.
10
潘啸东,李拥军,马根山. 血清C-反应蛋白对急性肺栓塞近期预后评估的初步研究[J]. 东南大学学报(医学版), 2010, 29(4): 459-461.
11
姚艳敏,徐彤彤,武琦,等. 瘦素对兔急性肺栓塞后TNF-αI、L-1β、Hs-CRP水平的影响[J]. 中国老年学杂志,2011, 31(20): 3977-3978.
12
Lacoma A, Prat C, Andreo F, et al. Value of procalcitonin, C-reactive protein, and neopterin in exacerbations of chronic obstructive pulmonary disease[J]. Int J Chron Obstruct Pulmon Dis, 2011, 28(6): 157-169.
13
吕亚辉,李洁. 联合检测BNP、TNI、CRP及D-二聚体在肺栓塞患者中的诊断、病情判定及预后的指导意义[J]. 中国医药导刊,2014, 16(10): 1290-1292.
14
Cay N, Ipek A, Gumus M, et al. Platelet activity indices in patients with deep vein thrombosis[J]. Clin Appl Thromb Hemost, 2012, 18(2): 206-210.
15
Cil H, Yavuz C, Islamoglu Y, et al. Platelet count and mean platelet volume in patients with in-hospital deep venous thrombosis[J]. Clin Appl Thromb Hemost, 2012, 18(6): 650-653.
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