Dissertation
Dissertation > Medicine, health > Internal Medicine > Respiratory system and chest diseases > Pulmonary disease > Pulmonary embolism

Correlation between BNP and Acute Submassive Pulmonary Thromboembolism

Author GuSongTao
Tutor WuZuo
School Tianjin Medical University
Course Internal Medicine
Keywords BNP submassive PTE risk stratification treatment prognosis
CLC R563.5
Type Master's thesis
Year 2011
Downloads 22
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Objective:Acute pulmonary embolism as a serious disease affecting human health, has attracted worldwide attention. Acute pulmonary embolism with a high incidence of missed diagnosis rate, high mortality, without treatment the mortality was 30%, active treatment can be reduced to 1% to 8%. The submassive pulmonary embolism is a subtype of acute pulmonary embolism, although this part of hemodynamically stable patients, but there are varying degrees of right ventricular dysfunction, right ventricular involvement in varying degrees, different treatment options, prognosis is not the same Therefore, the submassive pulmonary embolism for risk stratification, differential treatment, implementation of individualized treatment is essential.The study is to explore the clinical significance of BNP for risk stratification,treatment and prognosis in submassiv PTE.Methods:A total of 84 patients with confirmed submassive PTE were divided into two groups according to serum BNP levels,including Group A(n=50),BNP>90pg/mL and Group B(n=34),BNP≤90pg/mL.Meanwhile,the patients in Group A and Group B were respectively divided into two groups according the treatment:thrombolysis combined with anticoagulant therapy or simple anticoagulant therapy.The clinical feature,ECG,ABG,echocardiography and prognosis were analyzed and compared.Results:There were significant differences in dyspnea,chest pain,heart rate,respiratory frenquency,cyanosis,pericardial or pleural effusion,accentuated S2,abnormal myocardial enzyme, arterial blood PaO2,A-aDO2, oxygenation index,severity of ECQRAE or RVE,PASP,mid to deep degree of tricuspid regurgitation between Group A and B (P<0.05).There were significant differences in clinical key events:PTE recurrence,pulmonary artery hypertension,pneumocardial disease between Group A and B(P<0.05).There were significant differences in△PASP,therapeutic effect,pulmonary artery hypertension,pneumocardial disease between two sub-groups according to the treatment:thrombolysis combined with anticoagulant therapy or simple anticoagulant therapy of Group A.There were no significant differences between two sub-groups of Group B. Conclusion:The higher the serum BNP value, the more serious condition, the more dangerous the more complex course, higher mortality, the higher the incidence of clinical key events, the worse the prognosis. BNP in acute submassive pulmonary embolism risk stratification of patients has important clinical significance, and is a prognostic risk factor. Meanwhile, BNP can be used as a reference factor in thrombolytic therapy, but the BNP can guide thrombolytic therapy needs to be further study.

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