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利钠肽对肺栓塞合并肿瘤患者病情进展的影响

Impact of Natriuretic Peptide on the Evolution of Patients With Pulmonary Embolism and Neoplasm.

作者信息

Nemtut Daniela Maria, Ulmeanu Ruxandra, Németh Noémi, Tudoran Cristina, Motofelea Alexandru, Voita-Mekeres Florica, Lavinia Davidescu

机构信息

Cardiology, Pelican Hospital, Oradea, ROU.

Pulmonology, North Hospital, Provita Medical Group, Bucharest, ROU.

出版信息

Cureus. 2024 Nov 17;16(11):e73853. doi: 10.7759/cureus.73853. eCollection 2024 Nov.

Abstract

This retrospective study investigated the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in 106 patients with pulmonary embolism (PE) and associated oncological pathology. The study aimed to evaluate the predictive accuracy of NT-proBNP for both the prognosis and complication risk, such as early mortality (≤ 30 days), late mortality (≥ 30 days), and PE recurrence, in relation to the neoplasm's location and stage. Additionally, it explored the relationship between NT-proBNP, hemodynamic status (stable/unstable), and the location of PE in the pulmonary arteries (main, lobar, segmental) for prognostic and complication risk assessment. The results showed that cancer patients with NT-proBNP levels above 600 ng/L had a significantly higher risk of acute PE recurrence compared to those with lower levels, especially in cases involving the main pulmonary arteries. Hemodynamic instability further elevated the risk of PE recurrence and death, underscoring the importance of NT-proBNP as a prognostic marker for this population. Patients with unstable hemodynamic status were more likely to have elevated NT-proBNP levels, and this was associated with a markedly increased risk of early as well as late demise. Furthermore, patients with multiple tumor locations demonstrated a heightened risk of mortality when NT-proBNP levels were elevated. These findings highlight the potential of NT-proBNP as a valuable tool for risk stratification and patient management in individuals with PE and associated oncological pathology.

摘要

这项回顾性研究调查了N末端脑钠肽前体(NT-proBNP)在106例合并肿瘤病理学的肺栓塞(PE)患者中的预后价值。该研究旨在评估NT-proBNP对于与肿瘤位置和分期相关的预后及并发症风险(如早期死亡率(≤30天)、晚期死亡率(≥30天)和PE复发)的预测准确性。此外,研究还探讨了NT-proBNP、血流动力学状态(稳定/不稳定)以及PE在肺动脉中的位置(主肺动脉、叶动脉、段动脉)之间的关系,用于预后和并发症风险评估。结果显示,与NT-proBNP水平较低的癌症患者相比,NT-proBNP水平高于600 ng/L的癌症患者急性PE复发风险显著更高,尤其是在累及主肺动脉的病例中。血流动力学不稳定进一步增加了PE复发和死亡的风险,突显了NT-proBNP作为该人群预后标志物的重要性。血流动力学状态不稳定的患者更有可能出现NT-proBNP水平升高,这与早期和晚期死亡风险显著增加相关。此外,当NT-proBNP水平升高时,肿瘤多部位的患者死亡风险更高。这些发现突出了NT-proBNP作为PE合并肿瘤病理学患者风险分层和患者管理的有价值工具的潜力。

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