| Objective:Investigate muscle protein I, brain natriuretic peptide and right ventricular function and prognosis of changes in the value of patients with acute pulmonary embolism.Methods:Selected from May2005to February2013in hospital for treatment and diagnosis of acute hospitals in Dandong City, the first54cases of pulmonary embolism. All patients onset to admission time is not more than48hours; were carried plasma troponin I (cTnI) admission, brain natriuretic peptide (BNP), cardiac ultrasound. According plasma troponin I levels, patients were divided into groups of low cTnI (cTnI <0.40ng/ml) and high cTnI group (cTnI≥0.4ng/ml); According plasma brain natriuretic peptide levels, patients were divided into low-BNP group (BNP<100pg/ml) and high BNP group (BNP≥100pg/ml); according to echocardiographic right ventricular dysfunction were divided into groups with normal right ventricular function; According to the prognosis of death during hospitalization divided into groups and survivors; based on2001Chinese Society of Respiratory disease Association of pulmonary thromboembolism diagnosis and treatment guidelines (draft) patients were divided into; massive pulmonary embolism, sub massive pulmonary embolism, non-massive pulmonary embolism three groups. Observed incidence of adverse events among patients with different groups of patients and changes in cTnl and BNP concentrations during hospitalization.Result:l.cTnI concentration comparison; massive pulmonary embolism and sub massive pulmonary embolism in patients was significantly higher than non-massive pulmonary embolism [(2:05±0.70) ng/ml,(1.29±0.48) ng/ml vs (0.33±0.21) ng/ml, both P<0.01)]; death was significantly higher than the survival group [(1.97±0.56) ng/mlvs (1.00±0.85) ng/ml, P<0.01)]; right ventricular dysfunction was significantly higher than Right ventricular function in patients with normal group [(1.58±0.69) ng/mlvs (1.03±0.92) ng/ml, P<0.05)]; high BNP group was significantly higher than the low BNP group [(1.41±0.84) vs (0.36±0.48) ng/ml, P<0.01).2.BNP concentration comparison;massive PE and sub-massive PE was significantly higher in patients with non-massive PE patients [(788.21±512.53) pg/ml,(550.33±226.15) pg/mlvs (126.13soil126.16) pg/ml, P<0.01); death was significantly Higher than non-death patients [(980.55±552.73) pg/mlvs (364.83soil278.81) pg/ml, P <0.01); right ventricular dysfunction was significantly higher than normal right ventricular function group [(698.82±536.46) pg/mlvs (394.42±331.53) pg/ml, P <0.05)]; high cTnI group was significantly higher than the low cTnI group [(630.49±422.17) pg/mlvs (125.63±87.32) ng/ml, P<001)].(3) the incidence of adverse events during hospitalization different groups of patients;①high cTnI group adverse event rate was significantly higher than the low cTnI group (53.8%vsl3.3%, P <0.01), OR a value of7.6.②high incidence of adverse events was significantly higher than the low BNP BNP group (51.2%vs9.1%, P<0.05), OR is9.6.③right ventricular dysfunction incidence of adverse events was significantly Gao and right ventricular function in the normal group (64.7%vs35.1%, P<0.05), OR value of3.4.④right ventricular dysfunction and adverse event rates high cTnl group was significantly higher than normal right ventricular function and low cTnI group (66.7%vs12.5%, P <0.01), OR the value14.⑤right ventricular dysfunction and BNP high incidence of adverse events was significantly higher than normal right ventricular function and low-BNP group (73.3%vs8.3%, P<0.01), OR value of30.⑥bad high cTnI and high BNP group event rate was significantly higher than the low cTnI and low BNP group (60%vs10%, P<0.01), OR value of13.5.⑦right ventricular dysfunction, poor high cTnI and high BNP group event rate was significantly higher than normal right ventricular function, low cTnI and low BNP group (84.6%vs0%, P<0.01).4cTnI concentration and plasma BNP concentrations were positively correlated, the correlation coefficient was0.776.5right ventricular function, cTnl, BNP combination of both positive predictive value and specificity to predict the occurrence of adverse events compared with patients with a single index rose Gao, three highest combined when considered in patients with adverse events occurred during the joint can better predict hospitalization.Conclusion:1.Acute massive pulmonary embolism group, the group of death, right ventricular dysfunction in patients plasma cTnI, BNP concentrations were significantly increased, and the concentration was also found positive linear correlation between the two.2plasma cTnI (cutoff value0.40ng/ml) or BNP (cutoff value100pg/ml) as independent predictors of adverse events occurring during hospitalization in patients with pulmonary embolism.3Right ventricular function can be used as an independent predictor of adverse events occurring during hospitalization in patients with pulmonary embolism.4front right ventricular function and plasma cTnI their combination can better predict the occurrence of adverse events in patients with acute pulmonary embolism during hospitalization.5adverse events in patients with acute pulmonary embolism and right ventricular function during hospitalization and BNP joint can better forecast. The occurrence of adverse events during hospitalization6.cTnI and BNP two combined to better predict patients.7right heart function, the occurrence of cTnI and BNP combination of the three can be a better predictor of adverse events in patients during hospitalization. |
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