血清Apelin-13、可溶性血栓调节蛋白、锁链素对急性肺栓塞患者病情及预后的评估价值  

Value of serum Apelin-13,soluble thrombomodulin,and desmosine in the assessment of disease and prognosis of patients with acute pulmonary embolism

作　　者：朱迎伟[1] 褚旭 邱家勇 毛毅敏[1] 孙瑜霞[1] ZHU Ying-wei;CHU Xu;QIU Jia-yong;MAO Yi-min;SUN Yu-xia(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471003,China)

机构地区：[1]河南科技大学第一附属医院呼吸与危重症医学科,河南洛阳471003

出　　处：《临床肺科杂志》2021年第2期168-173,共6页Journal of Clinical Pulmonary Medicine

基　　金：河南省医学科技攻关计划(联合共建项目)(No.2018020285);洛阳市青年医学科技创新联合专项基金项目(No.1503008A-8)。

摘　　要：目的探究血清脂肪细胞因子13(Apelin-13)、可溶性血栓调节蛋白(sTM)、锁链素(DES)对急性肺栓塞(APE)患者病情及预后的评估价值。方法选取我院2017年10月~2019年8月APE患者118例作为观察组,另选取同期健康体检者115例作为对照组。于两组入院时检测血清Apelin-13、sTM、DES水平,对比两组及不同病情程度、不同预后患者血清Apelin-13、sTM、DES水平,分析其与病情程度的相关性,采用ROC曲线评价血清Apelin-13、sTM、DES对预后预测价值,Kaplan-Meier模型行生存分析。结果观察组血清Apelin-13、sTM、DES水平高于对照组(P<0.05);血清Apelin-13、sTM、DES水平随病情程度增加呈升高趋势(P<0.05);Spearman相关性分析,血清Apelin-13(r=0.402)、sTM(r=0.353)、DES(r=0.507)与病情程度呈正相关(P<0.05);死亡者入院时血清Apelin-13、sTM、DES水平高于生存者(P<0.05);Logistic回归显示:血清Apelin-13、sTM、DES是预后的显著影响因素(P<0.05);ROC曲线分析,血清Apelin-13、sTM、DES联合对预后预测价值AUC(0.895)>DES(0.807)>Apelin-13(0.728)>sTM(0.717),敏感度为80.00%,特异度为87.18%;K-M曲线分析,血清Apelin-13、sTM、DES水平高表达者生存率低于低表达者(P<0.05)。结论血清Apelin-13、sTM、DES与APE病情程度密切相关,有助于预测预后及生存状况,为临床诊治提供可靠参考依据。Objective To investigate the value of serum adipokine 13(Apelin-13),soluble thrombomodulin(sTM),and desmosine(DES)in the evaluation of the condition and prognosis of patients with acute pulmonary embolism(APE).Methods From October 2017 to August 2019,118 patients with APE in our hospital were selected as the observation group,and 115 patients with healthy physical examination during the same period were selected as the control group.Serum Apelin-13,sTM,and DES levels were measured at the time of admission between the two groups,and the serum Apelin-13,sTM,and DES levels were compared between the two groups and patients with different disease degrees and different prognosis,and analyzed their correlation with the degree of disease.ROC curve was used to evaluate the prognostic value of serum Apelin-13,sTM,and DES,and Kaplan-Meier(KM)curve was used for survival analysis.Results The levels of serum Apelin-13,sTM and DES in the observation group were higher than those in the control group(P<0.05).Serum Apelin-13,sTM,and DES levels increased with the increase of disease severity(P<0.05).Spearman correlation analysis showed that serum Apelin-13(r=0.402),sTM(r=0.353),and DES(r=0.507)were positively correlated with disease severity(P<0.05).The serum levels of Apelin-13,sTM and DES at admission was higher in the death group than in the survival group(P<0.05).Logistic regression showed that serum Apelin-13,sTM and DES were significant prognostic factors(P<0.05).The AUC of serum Apelin-13,sTM,and DES combined for predicting prognosis was the highest(0.895),followed by DES(0.807),Apelin-13(0.728),and sTM(0.717),with a sensitivity of 80.00%and specificity of 87.18%.KM curve analysis showed that the survival rate of those with high expression of serum Apelin-13,sTM and DES was lower than that of those with low expression(P<0.05).Conclusion Serum Apelin-13,sTM and DES are closely related to the severity of APE,which is helpful to predict the prognosis and survival status,and provide a reliable reference for clinical diagnosis an

关 键 词：急性肺栓塞 APELIN-13 可溶性血栓调节蛋白 锁链素 预后 

分 类 号：R563.5[医药卫生—呼吸系统] R446.11[医药卫生—内科学]