急性肺栓塞患者血浆TIMP-1,VEGF和LTBP-2水平表达与危险分层及死亡的相关性研究  

Study on the Correlation between the Expression of Plasma TIMP-1,VEGF and LTBP-2 Levels and Risk Stratification and Mortality in Patients with Acute Pulmonary Embolism

作　　者：许玫莎 王聪 郑友峰 吴挺实 肖成钦 陈伟 XU Meisha;WANG Cong;ZHENG Youfeng;WU Tingshi;XIAO Chengqin;CHEN Wei(Department of Respiratory,the Third People’s Hospital of Haikou,Haikou 571100,China)

机构地区：[1]海口市第三人民医院呼吸内科,海口571100

出　　处：《现代检验医学杂志》2025年第1期169-173,共5页Journal of Modern Laboratory Medicine

基　　金：海南省医药卫生科研基金项目(21A200156)。

摘　　要：目的 探讨急性肺栓塞(APE)患者血浆金属蛋白酶组织抑制因子-1(TIMP-1)、血管内皮生长因子(VEGF)及潜在转化生长因子结合蛋白2(LTBP-2)水平与危险分层和死亡的关系。方法 选取2022年1月~2024年1月海口市第三人民医院收治的APE患者110例进行危险分层,分为低危组(n=28)、中危组(n=43)和高危组(n=39);根据APE患者发生死亡情况分为存活组(n=79)和死亡组(n=31)。采用酶联免疫吸附法(ELISA)测定血浆TIMP-1,VEGF及LTBP-2水平;应用多元Logistic回归分析影响APE患者死亡的危险因素,绘制ROC曲线分析血浆TIMP-1,VEGF及LTBP-2水平预测APE患者死亡的价值;采用Pearson相关分析血浆TIMP-1,VEGF及LTBP-2水平与APE患者临床指标的相关性。结果 死亡组心率、B型脑钠肽(BNP)、D-二聚体、TIMP-1(207.15±62.84pg/ml vs 152.48±41.62pg/ml),VEGF(726.35±190.46pg/ml vs 419.27±115.28pg/ml)及LTBP-2(29.17±6.38ng/ml vs 13.26±3.70ng/ml)水平均明显高于存活组,差异具有统计学意义(t=5.386~21.194,均P<0.05)。高危组和中危组血浆TIMP-1(204.15±60.17 pg/ml,178.18±51.30pg/ml vs 148.20±34.80pg/ml),VEGF(720.83±204.18pg/ml,580.16±158.37pg/ml vs 412.15±109.26pg/ml)及LTBP-2(28.40±6.41ng/ml,21.37±5.26ng/ml vs 12.84±3.12ng/ml)水平均明显高于低危组(t=8.417~19.850),且高危组高于中危组(t=7.964,9.381,11.470),差异具有统计学意义(均P<0.05)。多元Logistic回归分析显示,血浆BNP,D-二聚体,TIMP-1,VEGF及LTBP-2水平升高是影响APE患者死亡的危险因素(均P<0.05)。ROC曲线分析显示,TIMP-1,VEGF及LTBP-2三项联合预测APE患者死亡的AUC(95%CI)最大[0.938(0.881~0.997)],其准确度为88.2%。Pearson相关分析显示,APE患者血浆TIMP-1,VEGF及LTBP-2水平与BNP及D-二聚体均呈正相关(r=0.416~0.753,均P<0.05)。结论 血浆TIMP-1,VEGF及LTBP-2水平升高与APE高危和死亡有关,三项联合对APE患者死亡具有较好的预测价值。Objective To investigate the relationship between plasma metalloproteinase-tissue inhibitor 1(TIMP-1),vascular endothelial growth factor(VEGF)and potentially transforming growth factor binding protein 2(LTBP-2)levels and risk stratification and death in patients with acute pulmonary embolism(APE).Methods A toral of 110 APE patients admitted to the Third People’s Hospital of Haikou from January 2022 to January 2024 were selected for risk stratification,and they were divided into low-risk group(n=28),medium-risk group(n=43)and high-risk groups(n=39).According to the occurrence of death in APE patients,they were divided into a survival group(n=79)and a death group(n=31).Enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of plasma TIMP-1,VEGF and LTBP-2.Applying multiple Logistic regression analysis to identify risk factors affecting the mortality of APE patients and plotting ROC curve to analyze the predictive value of plasma TIMP-1,VEGF and LTBP-2 levels for APE patients mortality and.Pearson correlation analysis was used to analyze the correlation between plasma levels of TIMP-1,VEGF and LTBP-2 and clinical indexes in APE patients.Results The heart rate,B-type brain natriuretic peptide(BNP),D-dimer,TIMP-1(207.15±62.84pg/ml vs 152.48±41.62pg/ml),VEGF(726.35±190.46pg/ml vs 419.27±115.28pg/ml)and LTBP-2(29.17±6.38ng/ml vs 13.26±3.70ng/ml)levels in the death group were significantly higher than those in the survival group,the difference were statistically significant(t=5.386~21.194,all P<0.05).The levels of plasma TIMP-1(204.15±60.17 pg/ml,178.18±51.30pg/ml vs 148.20±34.80pg/ml),VEGF(720.83±204.18pg/ml,580.16±158.37pg/ml vs 412.15±109.26pg/ml)and LTBP-2(28.40±6.41ng/ml,21.37±5.26ng/ml vs 12.84±3.12ng/ml)in high-risk and medium-risk groups were significantly higher than those in the low-risk group(t=8.417~19.850),and those in the high-risk group were higher than those in the medium-risk group(t=7.964,9.381,11.470),the differences were statistically significant(all P<0.05),respective

关 键 词：急性肺栓塞 金属蛋白酶组织抑制因子-1 血管内皮生长因子 潜在转化生长因子结合蛋白2 危险分层 死亡 

分 类 号：R563.5[医药卫生—呼吸系统] R392.11[医药卫生—内科学]