摘要
目的评价心肌型脂肪酸结合蛋白(H-FABP)对急性肺栓塞(APE)患者早期危险分层的预测价值。方法 2011年9月～2012年11月收治的APE患者60例,其中高危组14例、中危组26例和低危组20例。均于确诊后未行抗凝或溶栓治疗前检测血清H-FABP(>6.5 ng/mL判定为阳性);同时检测心率、SaO2、PaO2、D-二聚体(DD),并于就诊后24 h内行超声心动图检查,测定肺动脉压力、右心室内径、肺动脉内径、左室舒张末内径、左室射血分数。结果低、中、高危组心率、DD、H-FABP呈显著递增趋势,SaO2、PaO2呈显著递减趋势(P<0.05或0.01);H-FABP阳性与阴性者的呼吸困难发生率及右心室功能指标差异均有统计学意义(P<0.05)。结论血清H-FABP检测对于APE诊断明确者可用于病情判定、预后评估,与超声心动图等联合检测可对APE进行更为准确的危险分层。
Objective To evaluate the value of heart fatty acid binding protein （H-FABP） in the early risk stratification of acute pulmonary embolism （APE） patients. Methods Totally 60 patients with APE were enrolled in this study, and were divided into three groups according to risk stratification ： high risk group, moderate risk group and low risk group. The serum H-FABP level was detected after diagnosis and before treatment of antieoagulation or thrombolysis （ the positive standard is 〉 6.5 ng/mL） ; HR, SaO2, PaO2, D-Dimer （DD） were also detected, and the pulmonary artery pressure （PAP）, right ventricular internal dimension （RVID）, pulmonary artery internal dimension （PAID）, left ventricular diastolic end diameter（LVDED） and left ventricular ejection fraction （LVEF） were detected by echocardiography 24 hs after diagnosis. Results HR, DD and H-FABP increased progressively, SaO2 and PaO2 decreased progressively （P 〈 0. 05 or 0. 01 ） ; The incidence of dyspnea and indicators for the right ventricular function also showed significant differences（ P 〈 0. 05）. Conclusions Serum H-FABP can be used for the condition judgement and prognosis evaluation in patients with APE, and can provide precise risk stratification combined with echocardiography.
出处
《山东医药》
CAS
2013年第7期32-34,共3页
Shandong Medical Journal
关键词
急性肺栓塞
心肌型脂肪酸结合蛋白
右心室功能
危险分层
acute pulmonary embolism
fatty acid binding proteins
right ventricular function
risk stratification
