【摘要】 目的：探究孕妇产前血清脑钠肽(BNP)、肌钙蛋白(cTnI)及D-二聚体联合检测对孕产妇发生肺栓塞的预测价值。方法：收集2018年9月-2023年9月在本院和通用技术宝石花医疗吉林市化工医院产前检查且发生肺栓塞的孕产妇35例(观察组)、分娩未发生肺栓塞的孕产妇50例(对照组)临床资料。比较两组血清中BNP、cTnI及D-二聚体水平；多因素logistic回归分析孕产妇发生肺栓塞的影响因素；受试者工作特征(ROC)曲线分析产前血清BNP、cTnI及D-二聚体水平对孕产妇发生肺栓塞的预测价值。结果：观察组血清BNP(110.36±14.52 pg/ml)、cTnI(0.73±0.29 ng/ml)及D-二聚体(2.81±0.29μg/ml)均高于对照组(89.72±11.87 pg/ml、0.44±0.07 ng/ml、2.46±0.25μg/ml),血清BNP、cTnI及D-二聚体水平异常升高均为孕产妇发生肺栓塞的独立危险因素；产前血清BNP、cTnI、D-二聚体及3项联合预测孕产妇发生肺栓塞的曲线下面积分别为0.857、0.851、0.858、0.921,3项联合预测效能最高(均P<0.05)。结论：发生肺栓塞的孕产妇产前血清BNP、cTnI及D-二聚体水平均上调，且异常升高均为发生肺栓塞独立危险因素，3项联合对孕产妇发生肺栓塞有较高的预测价值。更多还原

【Abstract】 Objective:To explore the predictive value of the combined detections of prenatal serum brain natriuretic peptide(BNP),cardiac troponin I(cTnI) and D-dimer of pregnant women for their pulmonary embolism occurrence.Methods:The clinical data of 35 pregnant women with pulmonary embolism(in study group) and 50 pregnant women without pulmonary embolism(in control group) who underwent prenatal examinations in the hospital from September2018 to September 2023 were collected.Multivariate logistic regression was used to analyze the influencing factors of the pulmonary embolism occurrence of the pregnant women.Receiver operating characteristic(ROC) curve was used to analyze the predictive value of the prenatal serum BNP,cTnI and D-dimer levels of the women for their pulmonary embolism occurrence.Results:The levels of serum BNP(110.36±14.52 pg/ml),cTnI(0.73±0.29 ng/ml) and D-dimer(2.81±0.29μg/ml) of the women in the study group were significantly higher than those(89.72±11.87 pg/ml,0.44±0.07 ng/ml and 2.46±0.25μg/ml) of the women in the control group.The abnormal increase serum BNP,cTnI and D-dimer levels of the women were all the independent risk factors of their pulmonary embolism occurrence.The areas under the curve of the prenatal serum BNP level,the cTnI level,the D-dimer level and the combined prenatal serum BNP,cTnI,D-dimer levels of the women for predicting their pulmonary embolism occurrence were 0.857,0.851,0.858,0.921,respectively,and the combined prenatal serum BNP,cTnI,D-dimer levels of the women had the highest prediction efficiency(all P<0.05).Conclusion:The levels of prenatal serum BNP,cTnI,and D-dimer of the pregnant women with pulmonary embolism are up-regulation,and all of which are the independent risk factors of their pulmonary embolism occurrence.The combined prenatal serum BNP,cTnI,D-dimer levels of the women has higher prediction value for the pulmonary embolism occurrence of the women.更多还原