sPESI联合RDW、NLR、MLR对非高危急性肺栓塞患者早期风险的预测价值  

Predictive Value of sPESI Combined with RDW,NLR and MLR for Early Risk in Patients with Non-high-risk Acute Pulmonary Embolism

作　　者：张慧芳 郭奋凯 陈娟霞 刘美芳 马彬[1] 陈丽君[1] ZHANG Huifang;GUO Fenkai;CHEN Juanxia;LIU Meifang;MA Bin;CHEN Lijun(Department of Respiratory and Critical Care Medicine,The First People’s Hospital of Yinchuan,The Second Clinical Medical College of Ningxia Medical University,Yinchuan 750001,China;Department of Emergency Medicine,General Hospital of Ningxia Medical University,The First Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]银川市第一人民医院呼吸与危重症医学科,宁夏医科大学第二临床医学院,银川750001 [2]宁夏医科大学总医院急诊科,宁夏医科大学第一临床医学院,银川750004

出　　处：《宁夏医科大学学报》2024年第8期814-818,共5页Journal of Ningxia Medical University

基　　金：宁夏医科大学科学研究基金项目(XM2021090);自治区科技创新领军人才项目(2021GKLRLX03);自治区科技创新团队(2023CXTDO5)。

摘　　要：目的 探讨简化肺栓塞严重程度指数(sPESI)联合红细胞分布宽度(RDW)、中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)对非高危急性肺栓塞(APE)患者早期风险的预测价值。方法 收集2018年10月至2022年10月银川市第一人民医院收治的非高危APE患者,根据发病30 d内是否发生复合终点事件分为事件组和非事件组,分析两组患者sPESI评分及各临床指标的差异,寻找非高危APE患者发病30 d内发生复合终点事件的独立预测因子,绘制受试者工作特征(ROC)曲线,评价sPESI联合血常规指标对非高危APE患者早期风险的预测价值。结果 共纳入非高危APE患者187例,其中事件组49例、非事件组138例。两组间sPESI评分、RDW、NLR、MLR、血小板与淋巴细胞比值(PLR)、指脉氧饱和度(SpO2)、动脉血氧饱和度(SaO_(2))、白细胞(WBC)、C反应蛋白(CRP)、肌酐、N-端脑利钠肽前体(NT-proBNP)、乳酸脱氢酶(LDH)、胆碱酯酶、三酰甘油、Na^(+)差异均有统计学意义(P均<0.05)。二元Logistic回归分析结果显示,RDW、NLR、MLR是非高危APE患者发病30 d内发生复合终点事件的独立预测因子(P均<0.05)。绘制ROC曲线发现,sPESI曲线下面积(AUC)为0.761(95%CI:0.683~0.839),sPESI+RDW+NLR+MLR联合AUC为0.861(95%CI:0.774~0.909)。结论 sPESI联合RDW、NLR、MLR对非高危APE患者早期风险有较高的预测价值,可在基层医疗卫生机构推广应用。Objective To explore the predictive value of the simplified pulmonary embolism severity index(sPESI)in conjunction with red blood cell distribution width(RDW),neutrophil to lymphocyte ratio(NLR)and monocyte to lymphocyte ratio(MLR)for the early risk assessment of patients with non-high risk acute pulmonary embolism(APE).Methods Non-high risk APE patients admitted to the Yinchuan First People’s Hospital from October 2018 to October 2022 were collected.Patients were divided into event and non-event groups based on the occurrence of composite endpoint events within 30 days of onset.The study analyzed the differences in sPESI scores and various clinical indicators between the two groups to identify independent predictors for the occurrence of composite endpoint events in non-high risk APE patients within 30 days.Receiver operating characteristic(ROC)curves were drawn to evaluate the predictive value of combining sPESI with routine blood markers for early risk in non-high risk APE patients.Results This study included 187 non-high risk APE patients,with 49 in the event group and 138 in the non-event group.There were statistically significant differences between the two groups in terms of sPESI scores,RDW,NLR,MLR,platelet to lymphocyte ratio(PLR),oxygen saturation of the finger pulse(SpO2),arterial oxygen saturation(SaO_(2)),C-reactive protein(CRP),creatinine,N-terminal pro-brain natriuretic peptide(NT-proBNP),lactic dehydrogenase(LDH),cholinesterase,triglycerides,and Na(+P all<0.05).Binary Logistic regression analysis showed that RDW,NLR,and MLR were independent predictors of composite endpoint events within 30 days in patients with non-high risk APE(P all<0.05).ROC curve analysis revealed that the area under the curve(AUC)for sPESI was 0.761(95%CI:0.683-0.839),while the AUC for the combination of sPESI+RDW+NLR+MLR was 0.861(95%CI:0.774-0.909).Conclusion The combination of sPESI,RDW,NLR and MLR has a high predictive value for early risk in patients with non-high risk APE,especially suitable for implementation in prim

关 键 词：非高危急性肺栓塞 简化肺栓塞严重程度指数 血常规指标 预后 

分 类 号：R446.1[医药卫生—诊断学]