Ebrahimi Mohsen, Arab Mohammad Mohsen, Zamani Moghadam Hamid, Jalal Yazdi Majid, Rayat Doost Esmail, Foroughian Mahdi
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Arch Acad Emerg Med. 2022 Jan 8;10(1):e8. doi: 10.22037/aaem.v10i1.1453. eCollection 2022.
Pulmonary thromboembolism (PTE) is one of the most prevalent medical disorders, with a notable annual fatality rate. This study aimed to evaluated the accuracy of serum pro-BNP and troponin I levels in PTE diagnosis.
This cross-sectional study was implemented on 267 patients with suspected PTE (sudden chest pain or sudden dyspnea) in Imam Reza Hospital in Mashhad, Iran. All patients underwent pulmonary computed tomography (CT) angiography (as the gold standard test) and their serum levels of troponin I and pro-BNP were measured. The screening performance characteristics of pro-BNP in detection of PTE cases were measured and reported using receiver operating characteristic (ROC) curve analysis.
Two-hundred-sixty-seven patients with a mean age of 67.7 ±11.5 years were evaluated (60.1% male). PTE was confirmed via CT angiography in 121 patients. The area under the ROC curve of troponin I and pro-BNP in detection of PTE was 0.501 ng/mL and 0.972 pg/mL, respectively. The sensitivity and specificity of proBNP at the best cut-off point (100 pg/ml) were 85.4% and 80.2%, respectively. The sensitivity and specificity of troponin I at the best cut-off point (0.005 ng/ml) were 65.5% and 42%, respectively.
Due to the comparatively good sensitivity and specificity of proBNP in diagnosis of pulmonary thromboembolism, it can be employed as a diagnostic determinant in patients with suspected pulmonary thromboembolism along with other laboratory tests.
肺血栓栓塞症（PTE）是最常见的医学病症之一，年死亡率显著。本研究旨在评估血清脑钠肽前体（pro-BNP）和肌钙蛋白I水平在PTE诊断中的准确性。
本横断面研究在伊朗马什哈德伊玛目礼萨医院对267例疑似PTE（突发胸痛或突发呼吸困难）患者进行。所有患者均接受了肺部计算机断层扫描（CT）血管造影（作为金标准检查），并检测了他们的血清肌钙蛋白I和pro-BNP水平。使用受试者工作特征（ROC）曲线分析测量并报告pro-BNP在检测PTE病例中的筛查性能特征。
对267例平均年龄为67.7±11.5岁的患者进行了评估（男性占60.1%）。通过CT血管造影确诊121例PTE患者。肌钙蛋白I和pro-BNP在检测PTE时的ROC曲线下面积分别为0.501 ng/mL和0.972 pg/mL。pro-BNP在最佳临界点（100 pg/ml）时的敏感性和特异性分别为85.4%和80.2%。肌钙蛋白I在最佳临界点（0.005 ng/ml）时的敏感性和特异性分别为65.5%和42%。
由于pro-BNP在肺血栓栓塞症诊断中具有相对较好的敏感性和特异性，它可与其他实验室检查一起用作疑似肺血栓栓塞症患者的诊断指标。
