Diagnostic Value Of Troponin I,BNP And Myocardial Enzyme In Right Ventricular Dysfunction Of Patients With Nonhigh-risk Pulmonary Embolism

Background: Pulmonary embolism is a critical type of venous system thromboembolic disease.Pulmonary embolism with high rates of misdiagnosis and missed diagnosis,and high mortality rate has become one of the globally important health care problems.Therefore,timely diagnosis of pulmonary embolism can effectively save the patient's life and reduce mortality.As people's medical awareness increases,in order to save medical expenses and resources,heart-related biomarkers have become a commonly used diagnostic tool in the emergency of pulmonary embolism.Objective: To evaluate the diagnostic value of cardiac troponin I,BNP(brain natriuretic peptide),and myocardial enzymes for the prediction of non-high risk pulmonary embolism(PTE)in right ventricular dysfunction(RVD).Methods: This study used a retrospective study to collect 196 suspected PTE inpatients from January 01,2013 to May 1,2017,and excluded 47 patients(including46 insufficiency,unstable blood pressure,or 1 shock).149 cases.According to the results of CT pulmonary angiography(CTPA),two groups were divided into non-high-risk PTE and non-PTE groups.Non-high-risk PTE groups were diagnosed according to ultrasound cardiogram(UCG).Subdivided into two groups: RVD group and non-RVD group.The general conditions,clinical manifestations,past medical history,D-dimer,troponin I,BNP,and myocardium enzymes of the included cases were statistically analyzed and compared to evaluate the predictive value.Results: Of the 149 cases included in this study,66 were non-high-risk PTEs(32RVDs and 34 non-RVDs)and 83 non-PTEs.Among them,32 patients were RVD group,aged 68(60-80)years old,non-RVD group 34 patients,aged 63(53-72)years old,comparison between the two groups: Sa O2%(oxygen saturation),troponin,Creatine kinase(CK)and creatine kinase isoenzyme(CKMB)were not statistically different(P>0.05),age,BNP,lactate dehydrogenase(LDH),hydroxybutyrate dehydrogenase,D-dimer were statistically significant differences(P<0.05).The P values were 0.021,0.013,0.016,0.019,and 0.034 respectively.Non-high-risk PTE,both the non--pulmonary embolism contrast groups: D-dimer BNP,LDH,hydroxybutyrate dehydrogenase were significant differences(P <0.05),P values were0.000,0.000,0.004,0.000.Non-high-risk PTE and non-pulmonary embolism group: Ddimer,BNP,LDH,hydroxybutyrate dehydrogenase prediction operation subject area under the curve of the non-high-risk PTE were 0.716(P = 0.008),0.724(P = 0.006),0.813(P = 0.000),0.685(P = 0.024);BNP,LDH,hydroxybutyrate dehydrogenase and certain D-dimer,the correlation coefficients were 0.539(P = 0 000).,0.330(P=0.001),0.297(P=0.002).Conclusion:(1)Age is one of the risk factors for PTE onset;PTEs for acute or acute dyspnea should pay attention to the investigation of RVD;venous thrombosis of the lower extremities is a common source of PTE embolus;patients with venous thrombosis should pay attention to the disease and actively treat it;(2)D-Dimer,BNP,LDH,hydroxybutyrate dehydrogenase have certain predictive value for non-high-risk PTE;(3)BNP,LDH,hydroxybutyrate dehydrogenase,D-dimer can help diagnose whether non-high-risk PTE is associated with RVD;Improve CTPA and UCG diagnosis as soon as possible,and actively intervene in treatment,and avoid adverse events.