摘要
目的探讨脑钠肽(BNP)在评价急性肺栓塞(APE)右心功能不全(RVD)中的临床价值。方法回顾性分析我院74例经CTPA确诊的APE病例。根据心脏超声有无RVD表现,分为有RVD组和无RVD组。20多个临床及辅助检查变量为研究因素,RVD为相关因素,经Logistic回归多因素分析模型进行统计分析。通过ROC曲线分析BNP对RVD的诊断价值。结果 (1)单因素分析显示有RVD组心率快于无RVD组,血压高于无RVD组,BNP>100pg/m L者比率大于无RVD组,PaO_2、PaCO_2均低于无RVD组,Tv1-v4倒置比率大于无RVD组。(P<0.05)。(2)Logistic回归多因素分析模型显示BNP>100pg/m L和Tv1-v4倒置与RVD相关(P<0.05)。(3)BNP诊断RVD的ROC曲线下面积为0.800。结论 RVD组患者心肺功能指标差于无RVD组。BNP>100pg/m L、Tv1-v4倒置是RVD的预测因素。BNP对APE患者并发RVD有很好的诊断价值。
Objective To explore the clinical value of brain natriuretic peptide（ BNP） in evaluating right ventricular dysfunction（ RVD） in patients with acute pulmonary embolism（ APE）. Methods A retrospective study was employed. All 74 APE patients who were diagnosed by means of pulmonary CTA were enrolled into this study.They were divided into the RVD group and the no RVD group by echocardiography. More than twenty clinical and auxiliary examination variables were used as the research factors and RVD as the related factors. The date were analyzed with logistic regression model. The diagnostic value for BNP to predict RVD was analyzed by ROC curve. Results The univariate analysis showed that RVD was significantly associated with heart rate,blood pressure,BNP 100 pg/mL,arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide,and Tv1-v4 wave inversion（ P〈0. 05）. Logistic regression model showed RVD was associated with BNP 100 pg/mL and Tv1-v4 wave inversion（ P〈0. 05）. By ROC curve analysis,the area under the curve to predict RVD was 0. 800 for BNP. Conclusion The cardiopulmonary function of patients with RVD is inferior to patients without RVD. BNP 100 pg/mL and Tv1-v4 wave inversion can be used as predicted factors of RVD,which have good diagnostic value for BNP to diagnose RVD.
作者
张艳敏
王青松
ZHANG Yan-min;WANG Qing-song(Department of Respiratory Medicine, the Affiliated Hospital of Chengde Medical College, Chengde, Hebei 067000, Chin)
出处
《临床肺科杂志》
2018年第6期1094-1097,共4页
Journal of Clinical Pulmonary Medicine
关键词
肺栓塞
右心功能不全
脑钠肽
pulmonary embolism
right ventricular dysfunction
brain natriuretic peptide
