Bi Wenmiao, Liang Shaoqing, He Zhihong, Jin Ying, Lang Zhe, Liu Hongjuan, Wang Yi, Li Shuhong
Department of Respiratory Medicine, Shijiazhuang People's Hospital, Shijiazhuang, Hebei 050031, People's Republic of China.
Department of Emergency Medicine, Shijiazhuang People's Hospital, Shijiazhuang, Hebei 050031, People's Republic of China.
Int J Gen Med. 2021 Jan 28;14:303-308. doi: 10.2147/IJGM.S288975. eCollection 2021.
The present study aims to investigate whether the serum levels of brain natriuretic peptide (BNP), troponin I (TnI), and D-dimer, in addition to the neutrophil-to-lymphocyte ratio (NLR), can be used to determine the prognosis of patients with acute pulmonary embolism (APE).
Data were collected from 72 patients that were diagnosed with APE in our hospital from January 2015 to December 2018. These patients were divided into three groups: a high-risk group (n = 10), a moderate-risk group (n = 33), and a low-risk group (n = 29). The serum levels of BNP, TnI, and D-dimer were determined, and the NLR was measured. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the single and combined detection of BNP, TnI, and D-dimer, and the NLR was used to determine the prognosis of patients with APE.
The serum levels of BNP, TnI, and D-dimer were significantly higher in the high-risk group than they were in the moderate-risk and low-risk groups (P < 0.05). The serum levels of BNP, TnI, and D-dimer were also significantly higher in the moderate-risk group than they were in the low-risk group (P < 0.05). The serum levels of BNP, TnI, and D-dimer, as well as the NLR, were all significantly higher in the death group than they were in the survival group (P < 0.05). For the combined detection of the four indices, the area under the ROC curve was 0.92, the sensitivity was 0.889, and the specificity was 0.904; each of these values was higher than the corresponding values of single detection.
In patients with APE, higher serum levels of BNP, TnI, D-dimer and NLR are associated with a higher risk stratification, greater severity of disease, and an increased risk of death.
本研究旨在探讨除中性粒细胞与淋巴细胞比值(NLR)外,血清脑钠肽(BNP)、肌钙蛋白I(TnI)和D - 二聚体水平是否可用于确定急性肺栓塞(APE)患者的预后。
收集2015年1月至2018年12月在我院诊断为APE的72例患者的数据。这些患者分为三组:高危组(n = 10)、中危组(n = 33)和低危组(n = 29)。测定血清BNP、TnI和D - 二聚体水平,并测量NLR。采用受试者工作特征(ROC)曲线分析BNP、TnI和D - 二聚体单项及联合检测的诊断价值,并用NLR确定APE患者的预后。
高危组血清BNP、TnI和D - 二聚体水平显著高于中危组和低危组(P < 0.05)。中危组血清BNP、TnI和D - 二聚体水平也显著高于低危组(P < 0.05)。死亡组血清BNP、TnI和D - 二聚体水平以及NLR均显著高于存活组(P < 0.05)。对于四项指标的联合检测,ROC曲线下面积为0.92,灵敏度为0.889,特异度为0.904;这些值均高于单项检测的相应值。
在APE患者中,较高的血清BNP、TnI、D - 二聚体水平和NLR与更高的风险分层、更严重的疾病程度以及更高的死亡风险相关。