Correlation Analysis Of Amino-terminal Pro-brain Natriuretic Peptide And D-dimer With Pulmonary Artery Systolic Pressure In Patients With Acute Pulmonary Embolism

ObjectiveTo investigate the correlation between the levels of amino-terminal pro-brain natriuretic peptide and D-dimer in the serum of patients with acute pulmonary embolism complicated with pulmonary hypertension and pulmonary systolic pressure,so as to find early PH,timely and effective treatment,and reduce right ventricular dysfunction in patients with APE,reduce the mortality of APE,and improved prognosis.Methods1.A retrospective study was conducted to collect patients who were diagnosed with APE for the first time in the First Affiliated Hospital of Zhengzhou University from January 2017 to May 2018.PASP was measured by echocardiography and 65patients with PASP≥30 mmHg were enrolled.According to the size of PASP,there were 2 groups:22 cases of mild PH group(30mmHg≤PASP<50mmHg)and 43 cases of moderate to severe PH group(PASP≥50mmHg).Risk stratification was performed on enrolled patients according to the 2014 ESC published guidelines for the diagnosis and treatment of pulmonary embolism.Collect the patient’s general information,laboratory test results,imaging examination data,treatment plan and other indicators to analyze its relationship with pulmonary systolic pressure.2.Apply SPSS22.0 to statistical analysis of the data.The statistical description of the quantitative data should be expressed by the mean±standard deviation.The t test or the t test should be used for comparison between the two groups.The statistical description of the qualitative data should be applied to the frequency and percentage description.The comparison between groups was performed byχ~2 test;the quantitative data of both groups were consistent with the normal distribution and analyzed by Pearson correlation.If they did not meet the normal distribution or were graded,Spearman rank correlation was used,P<0.05,the difference was statistically significant.Results1.9 men(41%)and 13 women(59%)in the mild PH group;14(33%)men and29 women(67%)in the moderate-to-severe PH group,gender,age,and heart rate in the two groups There was no significant difference in blood pressure between the two groups(P>0.05).The symptoms were dyspnea in 52 patients(80.0%),syncope in 8patients(12.3%),hemoptysis in 4 patients(6.2%,3 patients with dyspnea,and 1patient).Combined with lower extremity edema,lower extremity edema in 5 cases(7.7%,4 cases with dyspnea),shock in 1 case(1.5%),chest pain in 6 cases(9.2%,2cases with dyspnea).2.PASP was closely related to risk stratification in APE patients(r=0.31,P<0.05).3.There was no statistically significant difference in the venous thrombosis of the lower extremities between the two groups(P>0.05).4.The level of NT-Pro BNP in the moderate-to-severe PH group was higher than that in the mild PH group(P<0.05).The D-Dimer level in the moderate-to-severe PH group was higher than that in the mild PH group(P<0.05).5.Serum NT-Pro BNP levels were positively correlated with PASP before treatment(r=0.75,P<0.05);D-Dimer levels were positively correlated with PASP before treatment(r=0.80,P<0.05);serum NT-Pro BNP levels There was a linear positive correlation with PASP after treatment(r=0.48,P<0.05).There was a linear positive correlation between D-Dimer level and PASP after treatment(r=0.46,P<0.05).Conclusions1.PASP is closely related to risk stratification in patients with APE.2.Serum NT-Pro BNP levels and D-Dimer levels are closely related to pulmonary artery pressure in APE patients.They can be used for early screening of high-risk patients with APE and PH,predicting PH occurrence,and NT-Pro BNP levels can be used to assess APE combined with PH.The severity of the patient’s condition has a certain guiding significance for clinical diagnosis and treatment.