摘要
目的研究血清正五聚蛋白3(PTX3)、肿瘤坏死因子-α(TNF-α)和D-二聚体(D-D)水平对肺血栓栓塞症(PTE)患者临床预后的预测价值。方法回顾性收集2016年12月至2021年12月在新疆维吾尔自治区喀什地区第二人民医院接受治疗的PTE患者263例,根据临床结局分为预后良好组(n=175)和预后不良组(n=88),根据肺栓塞相关诊断标准将PTE患者分为低危组(n=132)、中危组(n=110)和高危组(n=21)。比较各组患者血清PTX3、TNF-α和D-D水平,并通过Pearson法分析血清PTX3、TNF-α和D-D与APACHEⅡ评分的相关性,受试者工作特征(ROC)曲线评估血清PTX3、TNF-α、D-D水平和APACHEⅡ评分对PTE患者预后价值。结果预后良好组PTE患者血清PTX3、TNF-α和D-D水平分别为(3.18±1.21)ng/mL、(1.29±0.21)ng/mL、(0.85±0.18)mg/L,均显著低于预后不良组[(4.13±1.02)ng/mL、(1.58±0.22)ng/mL、(1.22±0.24)mg/L],差异均有统计学意义(P<0.05)。低、中、高危组PTE患者血清PTX3、TNF-α和D-D水平呈逐渐增高趋势,组间比较差异均有统计学意义(P<0.05)。Pearson法分析显示,PTE患者血清PTX3、TNF-α、D-D水平均与APACHEⅡ评分呈正相关(r=0.609、0.531、0.572,P<0.001)。ROC曲线分析显示:血清PTX3、TNF-α和D-D联合预测PTE患者死亡的曲线下面积、敏感度和特异度分别为0.890、85.9%和89.2%,均高于三者单独预测。结论血清PTX3、TNF-α、D-D水平上调,与PTE病情危险程度有关,血清PTX3、TNF-α和D-D水平,可有效预测PTE患者的临床预后。
Objective To study the predictive value of serum pentraxin 3(PTX3),tumor necrosis factor-α(TNF-α)and D-dimer(D-D)levels on the clinical prognosis of patients with pulmonary thromboembolism(PTE).Methods A retrospective collection of 263 PTE patients who were treated in The Second People's Hospital of Kashgar,Xinjiang Uygur Autonomous Region from December 2016 to December 2021.According to the clinical outcome,they were divided into pood prognosis group(n=175)and poor prognosis group(n=88).According to the PTE diagnostic criteria,they were divided into low risk group(n=95),intermediate risk group(n=76)and high risk group(n=15).The levels of serum PTX3,TNF-αand DD of patients in each group were compared,and the correlation of serum PTX3,TNF-αand DD between APACHEⅡscore were analyzed by Pearson method,the prognostic value of serum PTX3,TNF-α,D-D level and APACHEⅡscore in patients with PTE was evaluated by receiver operating characteristic(ROC)curve.Results The serum levels of PTX3,TNF-αand D-D in the PTE patients in the good prognosis group were(3.18±1.21)ng/mL,(1.29±0.21)ng/mL,(0.85±0.18)mg/L,which were significantly lower than those in poor prognosis group[(4.13±1.02)ng/mL,(1.58±0.22)ng/mL,(1.22±0.24)mg/L],the differences were statistically significant(P<0.05).The serum PTX3 and TNF-αand D-D levels in patients with PTE in low,medium and high risk groups gradually increased,the differences were statistically significant(P<0.05).Pearson method analysis showed that the levels of serum PTX3,TNF-α,D-D of PTE patients were positively correlated with their APACHE scores(r=0.609,0.531,0.572,P<0.001).ROC curve analysis showed that the area under cure,sensitivity and specificity of serum PTX3,TNF-αand D-D combined to predict death of PTE patients were 0.89,85.9%,and 89.2%,respectively,which were higher than those predicted by the three alone.Conclusion The up-regulation of serum PTX3,TNF-αand D-D levels is related to the risk of pulmonary thromboembolism.Serum PTX3,TNF-αand D-D levels can be effective in
作者
王阿红
王怀振
刘亚冲
迪力努尔·阿不力克木
陈湘陶
WANG A-hong;WANG Huai-zhen;LIU Ya-chong(Department of Respiratory and Critical Care Medicine,the Second People's Hospital of Kashgar,Xinjiang Uygur Autonomous Region,Kashgar Xinjiang 844000,China)
出处
《临床和实验医学杂志》
2022年第23期2498-2501,共4页
Journal of Clinical and Experimental Medicine
基金
新疆维吾尔自治区天山青年计划项目(编号:2019Q147)。
