The Clinical Significance Of Combined Detection Of Troponin And N-terminal Pro-brain Natriuretic Peptide In Acute Pulmonary Embolism

Objective:To explore the concentration change,the diagnostic and prognostic clinical meaning of cardiac troponin I(cTnI)and amino-terminal brain natriuretic peptide precursor(NT-proBNP)in acute pulmonary embolism(APE)patients.Methods:42 APE patients from June 2014 to December 2015 of Central Hospital of Lin Yi were selected as experimental group,all patients were diagnosed by computer tomography pulmonary angiography(CTPA).All patients did color Doppler echocardiography in 48 hours after admission.The basic information,symptoms,signs and risk factors of the 42 patients were recorded.Severe adverse events were recorded during hospitalization,including shock,endotracheal intubation,mechanical ventilation,cardiopulmonary resuscitation,and death,According to the clinical outcome,APE patients were divided into good outcome group and bad outcome group,and 40 healthy people for physical examination in our hospital at the same period were selected as control group.The distribution of basic data,symptoms,signs and risk factors in the experimental group were analyzed.The concentration of cTnI and NT-proBNP in experimental group and control group,in good outcome group and bad outcome group,was compared respectively.Results:Among the 42 patients in the experimental group,the most common symptoms were dyspnea(61.9 %),chest pain(30.9 %),syncope(19 %),shock(11.9 %),and hemoptysis(9.5%),and the most common sign was tachycardia(heart rate >100 / score)(47.6 %).Most of the patients have one or more known risk factors,such as lower limbs or pelvic fractures,severe trauma,a long history of smoking,combined varicose veins of lower extremity,and deep venous thrombosis.APE group:cTnI of is(1.2±0.56)ng/mL,NT-proBNP is(1223±445)pg/mL,control group:cTnI is(0.1±0.13)ng/mL,NT-proBNP is(40±17.4)pg/mL,the difference was statistically significant(P<0.05).In the APE patients,bad outcome group: cTnI is(3.3±1.56)ng/ml,NT-proBNP is(4483±960)pg/mL,good outcome group : cTnI is(0.7±0.37)ng/ml,NT-proBNP is(562±118)pg/m L,the difference was statistically significant(P<0.05).The concentration of cTnI and NT-proBNP in experimental group was significantly higher than that of control group,and the concentration of cInI and NT-proBNP in bad outcome group was higher than that of good outcome group,the difference was statistically significant(P<0.05).Conclusion:1.More and more acute pulmonary embolism is seen in clinic.Its condition is heavy,the mortality rate is high,misdiagnosis and missed diagnosis rate is high.In clinical work,for suspected pulmonary embolism patients,D-two polymer,echocardiography,spiral CT should be combined to improve the diagnosis rate and give the targeted treatment as early as possible in order to save the patient’s life.Life.2.The level of plasma amino terminal natriuretic peptide precursor(NT-proBNP)and troponin(cTn)is of good clinical significance for the diagnosis and diagnosis of acute pulmonary embolism.It can also be used as an indicator of the severity and prognosis of pulmonary embolism.