新型炎症指标对急性肺栓塞的诊断价值  

Application of novel inflammatory factors in acute pulmonary embolism

作　　者：陈安琪 高悦 吴云 Chen An-qi;GAO Yue;WU Yun(Inner Mongolia Medical College of Inner Mongolia Medical University,Huhhot,Inner Mongolia 010013,China;Physical Examination Center,the Third Hospital of Inner Mongolia Autonomous Region,Huhhot,Inner Mongolia 010050,China;Heart Center,Inner Mongolia Autonomous Region People′s Hospital,Huhhot,Inner Mongolia 010010,China)

机构地区：[1]内蒙古医科大学内蒙古临床医学院,内蒙古呼和浩特010013 [2]内蒙古自治区第三医院体检中心,内蒙古呼和浩特010050 [3]内蒙古自治区人民医院心脏中心,内蒙古呼和浩特010010

出　　处：《临床肺科杂志》2023年第4期579-584,共6页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨新型炎症指标在急性肺栓塞(Acute Pulmonary Embolism,APE)的诊断价值。方法纳入2018年1月至2022年5月内蒙古自治区人民医院就诊的280例首发APE患者,选取同期我院入院或健康体检者281例作为对照组,对两组人群一般资料和实验室指标进行相关性分析,构建Logistic回归模型分析新型炎症指标与APE发生的关系,最后绘制新型炎症指标诊断APE的ROC曲线。结果APE组D-二聚体、纤维蛋白原、单核细胞数/高密度脂蛋白胆固醇(Monocyte to High-density lipoprotein cholesterol Ratio,MHR)均显著高于对照组(P<0.001);APE组白蛋白、中性粒细胞数/淋巴细胞数(Neutrophil to Lymphocyte Ratio,NLR)、白蛋白/纤维蛋白原比值(Albumin-to-Fibrinogen Ratio,AFR)均显著低于对照组(P<0.001);由相关分析结果可知患APE与D-二聚体和MHR为显著正相关(P<0.05),与NLR、AFR、白蛋白均为显著负相关(P<0.05);Logistic回归模型分析显示MHR为患APE的独立危险因素(P<0.05),NLR和AFR为患病保护因素(P<0.05);以NLR、MHR、AFR、D-二聚体四个指标及联合诊断绘制ROC曲线显示,联合D-二聚体、AFR、NLR诊断的准确率最高,AUC值为0.955。结论新型炎症指标MHR在APE组水平明显升高,NLR和AFR在APE组水平明显降低,MHR水平可能是APE患者的独立危险因素,通过检测上述三个新型炎症指标用于诊断APE具有一定的临床价值。Objective To investigate the diagnostic value of novel inflammatory factors in acute pulmonary embolism(APE).Methods From January 2018 to May 2022,280 APE patients for the first visit were enrolled in the Inner Mongolia Autonomous Region People′s Hospital,and 281 healthy cases were selected as the control group,the general and laboratory characteristics of the two groups were analyzed.We conducted the correlation of various inflammatory factors,and the relationship between the novel inflammatory factors and APE was analyzed,then the ROC curve of the novel inflammatory marker diagnosing APE was drawn.Results In the APE group,D-dimer,fibrinogen and MHR were significantly higher than those in the control group(P<0.001),and AFR,albumin and NLR were significantly lower than those in the control group(P<0.001).From the analysis,it showed that APE was significantly positively correlated with D-dimer and MHR(P<0.05),and was significantly negatively correlated with NLR,AFR,and albumin(P<0.05).In order to explore the influencing factors of the disease,logistic regression analysis was established with APE as the dependent variable,NLR,MHR,AFR as the independent variables,and the results showed that MHR was an independent risk factor for APE(P<0.05),NLR and AFR were the protective factors for disease(P<0.05).The ROC curve was plotted based on the four indicators of NLR,MHR,AFR,D-dimer and combined diagnosis.From the ROC curve,the diagnosis efficiency of combined D-dimer,AFR,and NLR had the highest accuracy,and the AUC value was 0.955.Conclusion The levels of novel inflammatory factors MHR in the APE group is significantly increased,the levels of NLR and AFR in the APE group are significantly reduced,and the MHR level may be an independent risk factor for APE patients,and the above three novel inflammatory factors are used for diagnosis of APE with certain clinical value.

关 键 词：急性肺栓塞 炎症 白蛋白/纤维蛋白原 单核细胞数/高密度脂蛋白胆固醇 中性粒细胞数/淋巴细胞数 

分 类 号：R563.5[医药卫生—呼吸系统]