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-  2015 

探讨高敏肌钙蛋白I用于评估急性肺栓塞患者预后的价值

DOI: doi:10.7507/1671-6205.2015068

Keywords: 急性肺栓塞, 高敏肌钙蛋白I, 简化肺栓塞严重指数, 预后

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Abstract:

目的探讨高敏肌钙蛋白I(hs-cTnI)阴性结果在筛选急性肺栓塞(APE)低危患者中的预测价值。 方法回顾性分析272例在北京安贞医院住院的APE患者的临床资料以及30 d内不良事件发生情况。根据hs-cTnI测定结果,将患者分为高hs-cTnI组和低hs-cTnI组。应用简化肺栓塞严重指数(sPESI)进行临床风险评估。不良事件定义为30 d内死亡、出现严重并发症、需要溶栓治疗或机械通气。绘制不同hs-cTnI水平组患者的生存曲线。应用多因素Logistic逐步回归模型进行统计分析。 结果高hs-cTnI组30 d内死亡、急性肾功能衰竭、出血及需要溶栓治疗的比例分别为6.1%、14.6%、13.4%和7.9%,均显著高于低hs-cTnI组(P值分别为0.009、<0.001、0.018和0.003)。在sPESI评分≥1组中,低hs-cTnI患者不良事件的发生率明显低于高hs-cTnI患者(P=0.005)。sPESI预测APE患者不良预后的χ2值为11.25(P=0.001),加入hs-cTnI后χ2值升高至26.25(P<0.001)。 结论hs-cTnI在评估APE短期预后时具有良好的阴性预测价值,且在sPESI基础上可显著增加对APE短期预后的预测能力

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