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低的脑前性尿素水平预测急性肺栓塞的良性临床结果

Nils Kucher¹, Gert Printzen, Tanja Doernhoefer

¹Swiss Cardiovascular Center, Cardiology, University Hospital, Bern, Switzerland. nkucher@partners.org

|April 2, 2003

概括

低的脑前性尿素 (proBNP) 水平有效预测急性肺栓塞 (PE) 患者的医院治疗过程有利. 低于500 pg/mL的proBNP确定了适合短期住院或门诊治疗的个人.

科学领域:

心脏病学心脏病学
肺部医学肺部医学
生物标志物研究生物标志物研究

背景情况:

亲脑尿素 (proBNP) 对急性肺栓塞 (PE) 的临床结果的预测价值尚未先前确定.
急性PE是致病率和死亡率的重要原因,需要准确的预后工具.

研究的目的:

研究proBNP在预测急性肺栓塞 (PE) 诊断患者的临床结果中的作用.
确定低proBNP水平是否可以识别低不良事件风险的患者,从而减少住院时间.

主要方法:

在入院4小时内测量了73名急性PE患者的ProBNP水平.
临床不良结果被定义为在医院死亡或需要进行心肺复苏,机械呼吸,压力器,血栓溶解或栓塞切除等干预措施.
统计分析包括对不同组的proBNP水平进行比较,并在对临床因素进行调整后评估其独立的预测值.

主要成果:

与良性结局 (121 pg/mL;P<0.0001) 患者相比,具有不良临床结局的患者的中位数proBNP水平 (4250 pg/mL) 显著更高.
低于500 pg/mL的proBNP水平显示了对不良临床结果的97%负预测值.
即使在调整了PE严重程度,托波宁T,年龄,性别和心力衰竭史之后,ProBNP仍然是不良结果的独立预测因素 (OR 14.6,P=0.02).

结论:

在被诊断为急性PE的患者中,低proBNP水平表明无事件的住院过程.
<500 pg/mL的proBNP值可以识别急性PE患者适合缩短住院或门诊管理,优化资源利用.

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