Clinical Significance Of Brain Natriuretic Peptide Combined With Cadiac Troponin Ⅰ And D-dimer In Acute Pulmonary Embolism

Objective:To study the level change of brain natriuretic peptide(BNP), cardiac troponin Ⅰ (cTn Ⅰ) and D-dimer in48patients with acute pulmonanry embolism and to evaluate the clinical significance of plasma BNP、cTn Ⅰ and D-dimer to the diagnosis of acute pulmonary embolism.Methods:Chosed48patients with acute pulmonanry embolism in the second affiliated hospital of Kunming medical university in Desember2011to Octorber2012.All cases were diagnosed by computer tomography pulmonary angiography(CTPA).Devided the patients into two groups based on serious clinical manifestations (cardiogenic shock or hypotension):the group with massive pulmonary emobolism and the group with non-massive pulmonary embolism.Plasma BNP、cTn Ⅰ and D-dimer level were detected by ELISA.All patients have done color doppler echocardigraphy in48hours after admission.Otherwise,we analysed and compared the level of plasma BNP, cTn Ⅰ and D-dimer,the right ventricular function,death rate and the days in hospital in two groups. Results:In the48cases with acute pulmonanry embolism (APE),21cases with massive pulmonary embolism and27cases with non-massive pulmonary embolism.The level of plasma BNP and cTn I had significant difference between group with massive pulmonary embolism and group with non-massive pulmonary embolism.The frequen-ce of serious clinical magnifestation as cardiogenic shock or hypotension and the death rate in group with massive pulmonary embolism are higher than that in the group with non-massive pulmonary embolism.The frequence of right ventricular dysfunction in the group of massive pulmonary embolism is higher than that in non-massive pulmonary embolism. There was no significant difference between the extent of D-dimer increase and the severity of PE in group with massive pulmonary and group with non-massive pulmonary embolism.Conclusion:Brain natriuretic peptide(BNP) combine with cardiac troponin Ⅰ (cTnⅠ) and D-dimer is a good way to help risk stratification of acute pulmonary embolism(APE),guid treatment and prognosis.