The Relationship Between Lung Infarct Area And Biochemical Marker In Patients With Pulmornay Embolism

Background and ObjectivesPulmonary thromboembolism (PTE) is a common disease with substantial morbidity and mortality, and the third leading cause of death in western countries apart from cancers and heart diseases. The quick evaluation of the diagnosis and prognosis of PTE remains a challenge for the physicians. The pathophysiology of PTE involves cardiovascular and pulmonary systems. Because the massive PTE is life-threatening, it is important to predict the prognosis of massive PTE patients by noninvasive techniques and give initial managements as soon as possible.Objects and Methods97 patients were diagnosed as PTE by ventilation/perfusion lung scan, computed tomographic pulmonary arteriography or lung magnetic resonance imaging in our hospital from Jun, 2002 to Dec, 2005. 52 patients were classified as the massive group and 45 patients were in the nonmassive group by heart ultrasonic scanning based on the Goldhaber grading system. D-dimer, thrombophilia tests, arterial blood gases and cardiac enzymes were measured. The information of admission of intense care unit, using of respiratory machines and PE-related mortality were collected and compared between two groups.ResultsValues of D-dimer, thrombophilia tests, arterial blood gases and cardiac enzymes tests were collected retrospectively among PTE patients. There were significant differences in alveolar - arterial partial pressure of oxygen (P(A-a)O₂), arterial partial pressure of carbon dioxide PaCO₂ between two groups. The abnormality of PT, APTT and international normalized ratio (INR) showed the severe coagulative conditions in the massive PTE group. No differences were observed in cardiac enzymes tests between two different PTE patients. Massive PTE group represented greater adverse medical outcomes such as admission ofintense care unit and using of respiratory machines, and high risk of death than non massive group.Conclusions1. Deteriorating D-dimer values and thrombophilia tests suggest that confirmed PTE patients have poor prognoses. Arterial blood gases are useful predictors for the cardiac and pulmonary functions of PTE patients.2. We should do further study assessment the value of cardiac muscle enzyme o...