血清H-FABP、Copeptin及PaO_(2)/FiO_(2)与急性肺栓塞病情的关系及预后预测模型构建  

Relationship between serum H-FABP,Copeptin,PaO_(2)/FiO_(2) and the disease of acute pulmonary embolism and construction of prognosis prediction model

作　　者：董青利 李雯 DONG Qingli;LI Wen(Department of Clinical Laboratory,Weinan First Hospital,Weinan,Shaanxi 714000,China;Department of Laboratory Blood Transfusion,Xi′an Ninth Hospital,Xi′an,Shaanxi 710054,China)

机构地区：[1]陕西省渭南市第一医院检验科,陕西渭南714000 [2]陕西省西安市第九医院检验输血科,陕西西安710054

出　　处：《检验医学与临床》2023年第15期2149-2153,共5页Laboratory Medicine and Clinic

基　　金：陕西省2021年科技计划青年项目(2021QJ-561)。

摘　　要：目的 探讨血清心肌型脂肪酸结合蛋白(H-FABP)、和肽素(Copeptin)及氧合指数(PaO_(2)/FiO_(2))与急性肺栓塞病情程度的关系,并构建预后预测模型。方法 选取2019年11月至2021年11月渭南市第一医院收治的124例急性肺栓塞患者作为研究对象,比较不同病情程度患者之间血清H-FABP、Copeptin及PaO_(2)/FiO_(2)的差异,比较预后不良组和预后良好组患者的血清H-FABP、Copeptin及PaO_(2)/FiO_(2)水平,通过多因素Logistic回归分析急性肺栓塞患者预后不良的影响因素,绘制受试者工作特征(ROC)曲线分析H-FABP、Copeptin及PaO_(2)/FiO_(2)对急性肺栓塞患者预后不良的预测价值,并构建预后预测模型。结果 高危组患者血清H-FABP、Copeptin水平明显高于中危组和低危组,PaO_(2)/FiO_(2)明显低于中危组和低危组,差异均有统计学意义(P<0.05)。预后不良组患者血清H-FABP、Copeptin水平显著高于预后良好组,PaO_(2)/FiO_(2)显著低于预后良好组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示:脑钠肽、心肌肌钙蛋白I、H-FABP、Copeptin水平升高是急性肺栓塞患者预后不良的独立危险因素(P<0.05),PaO_(2)/FiO_(2)升高是急性肺栓塞患者预后不良的保护因素(P<0.05)。ROC曲线结果显示,H-FABP、Copeptin、PaO_(2)/FiO_(2)对急性肺栓塞患者预后不良具有较高的预测价值,且联合预测效能更佳,其曲线下面积为0.874。结论 H-FABP、Copeptin及PaO_(2)/FiO_(2)水平与急性肺栓塞病情程度预测有一定的关系,基于H-FABP、Copeptin及PaO_(2)/FiO_(2)构建的预后预测模型对急性肺栓塞患者预后不良的效能较高,可辅助用于急性肺栓塞患者的预后评估。Objective To investigate the relationship between serum myocardial fatty acid binding protein(H-FABP),Copeptin,Peptin and oxygenation index(PaO_(2)/FiO_(2))and the degree of disease of acute pulmonary embolism,and to construct a model for prognosis prediction.Methods A total of 124 patients with acute pulmonary embolism admitted to Weinan First Hospital from November 2019 to November 2021 were selected.To compare the difference of serum H-FABP,Copeptin and PaO_(2)/FiO_(2) among patients with different degree of disease.Serum H-FABP,Copeptin and PaO_(2)/FiO_(2) were compared between the poor prognosis group and the good prognosis group.Multivariate Logistic regression was used to analyze the fators influencing poor prognosis in patients with acute pulmonary embolism.The predictive value of H-FABP,Copeptin and PaO_(2)/FiO_(2) for poor prognosis was analyzed by the receiver operating characteristic(ROC)curve,and a prognostic prediction model was constructed.Results The levels of H-FABP and Copeptin in the high-risk group were significantly higher than those in the intermediate-risk group and the low-risk group,and the PaO_(2)/FiO_(2) was significantly lower than that in the intermediate-risk group and the low-risk group,the differences had statistical significance(P<0.05).The levels of H-FABP and Copeptin in the poor prognosis group were significantly higher than those in the good prognosis group,and PaO_(2)/FiO_(2) was significantly lower than that in the good prognosis group,the differences had statistical significance(P<0.05).Multivariate Logistic regression analysis showed that the increased levels of brain natriuretic peptideand cardiac troponin I,H-FABP and Copeptin were independent risk factors affecting the poor prognosis of patients with acute pulmonary embolism(P<0.05),and the increased PaO_(2)/FiO_(2) was a protective factor for poor prognosis of patients with acute pulmonary embolism(P<0.05).The results of ROC curve showed that H-FABP,Copeptin and PaO_(2)/FiO_(2) had high predictive value for the risk of

关 键 词：心肌型脂肪酸结合蛋白 和肽素 氧合指数 急性肺栓塞 模型构建 

分 类 号：R563.5[医药卫生—呼吸系统]