Department of Internal Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.
Clin Appl Thromb Hemost. 2011 Nov-Dec;17(6):E153-7. doi: 10.1177/1076029610392215. Epub 2011 Feb 8.
The purpose of this investigation is to assess the prevalence of elevated cardiac biomarkers, with or without estimates of right ventricular (RV) size, in stable patients with acute pulmonary embolism (PE). Our hypothesis is that the combination of high levels of cardiac troponin I (cTnI), high creatine kinase isoenzyme MB (CK-MB), and normal size RV are sufficiently uncommon in stable patients with PE to make the diagnosis of PE unlikely. Retrospective review showed a high cTnI plus high CK-MB in 20 (3.4%) of 585 stable patients with acute PE. A high cTnI plus high CK-MB with normal RV size was shown in 5 (1.9%) of 264 patients. In stable patients with such findings, therefore, PE is unlikely and other diagnoses, particularly acute coronary syndrome, should be considered before pursuing a diagnosis of PE.
本研究旨在评估急性肺栓塞（PE）稳定患者中心脏生物标志物升高的发生率，无论是否估计右心室（RV）大小。我们的假设是，在稳定的 PE 患者中，高心脏肌钙蛋白 I（cTnI）、高肌酸激酶同工酶 MB（CK-MB）和正常大小的 RV 结合在一起的情况非常罕见，以至于不太可能诊断为 PE。回顾性分析显示，在 585 例急性 PE 稳定患者中，有 20 例（3.4%）存在高 cTnI 和高 CK-MB。在 264 例 RV 大小正常的患者中，有 5 例（1.9%）存在高 cTnI 和高 CK-MB。因此，在有这些发现的稳定患者中，不太可能诊断为 PE，应在诊断 PE 之前考虑其他诊断，特别是急性冠状动脉综合征。
