Devrek State Hospital, Department of Chest Deseases, Zonguldak, Turkey.
Van Yüzüncü Yıl University Faculty of Medicine Department of Chest Deseases, Van, Turkey.
Respir Med. 2024 Nov;233:107776. doi: 10.1016/j.rmed.2024.107776. Epub 2024 Aug 26.
The objective was to evaluate the serum levels of neutrophil gelatinase-associated lipocalin (NGAL), hypoxia-induced factor-1 alpha (HIF-1α), and apelin 13 in patients with acute pulmonary thromboembolism (PE) and to investigate their diagnostic and prognostic role in PE patients with different mortality risk groups.
This study was conducted in a tertiary referral center and included 124 subjects with 94 cases of PE and 30 cases of healthy control group. All subjects were 18 years of age or older. The diagnosis of PE was done with computed tomography angiography of the thorax. After the diagnosis of acute PE, the serum levels of neutrophil gelatinase-associated lipocalin (NGAL), hypoxia-induced factor-1 alpha (HIF-1α), and apelin 13 levels were measured with a commercial enzyme-linked immunosorbent assay (ELISA) kit.
The median and IQR (interquartile range) age of patients and control groups were 68 (56-76) and 61.5 (56-67) years, respectively. The majority of patients with PE had risk factors (97.88 %), and only two (2.12 %) had no known risk factors. HIF-1 alpha level was found to be higher in the patient group than in the control group (p = 0.03). At the same time, the HIF-1 alpha level was found to be higher in the high mortality risk group than in the control group, low mortality risk group and intermediate-low mortality risk group (p = 0.000, 0.011, 0.002, respectively). While there was no significant difference in NGAL level between the patient group and the control group, a significant difference was observed between the mortality groups. NGAL level was found to be higher in the high mortality risk group than the control group, low mortality risk group, and medium-low mortality risk group (p = 0.001, 0.000, 0.010, respectively). Apelin 13 levels did not differ significantly in all groups.
HIF-1 alpha is a promising biomarker in distinguishing between patients and control groups and in identifying those with high mortality risk in the patient group. At the same time, NGAL can be used as a successful biomarker in determining the group with high mortality risk in cases of PE.
评估急性肺血栓栓塞症（PE）患者血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、缺氧诱导因子-1α（HIF-1α）和apelin 13 的水平，并探讨其在不同死亡风险组 PE 患者中的诊断和预后作用。
本研究在一家三级转诊中心进行，纳入 124 例患者，其中 94 例为 PE 患者，30 例为健康对照组。所有患者年龄均在 18 岁或以上。采用胸部 CT 血管造影诊断 PE。PE 诊断后，采用商业酶联免疫吸附试验（ELISA）试剂盒检测血清 NGAL、HIF-1α和 apelin 13 水平。
患者组和对照组的中位数和 IQR（四分位距）年龄分别为 68（56-76）和 61.5（56-67）岁。大多数 PE 患者有危险因素（97.88%），只有 2 例（2.12%）无已知危险因素。与对照组相比，患者组 HIF-1α水平较高（p=0.03）。同时，高死亡风险组 HIF-1α水平高于对照组、低死亡风险组和中低死亡风险组（p=0.000、0.011、0.002）。而 NGAL 水平在患者组和对照组之间无显著差异，但在死亡组之间有显著差异。高死亡风险组 NGAL 水平高于对照组、低死亡风险组和中低死亡风险组（p=0.001、0.000、0.010）。各组间 apelin 13 水平无显著差异。
HIF-1α是区分患者和对照组以及识别患者中高死亡风险人群的有前途的生物标志物。同时，NGAL 可作为 PE 患者中确定高死亡风险组的成功生物标志物。
