摘要
[目的]探讨单核细胞计数与高密度脂蛋白比值(MHR)及全身免疫炎症指数(SII)对预测急性肺栓塞(APE)患者病情严重程度及院内死亡情况的临床价值.[方法]选择于2016年3月至2022年5月间行选择性肺动脉造影检查明确诊断为APE的164例患者作为研究对象,按照肺栓塞严重程度指数(PESI)分为低危组(n=38)、中危组(n=84)和高危组(n=42),根据患者院内生存情况分为生存组(n=138)和死亡组(n=26).收集所选患者的年龄、性别、身高、体质量等一般临床资料及血常规、D-D、NTProBNP、CRP、血脂及出凝血时间等实验室指标,计算MHR和SII值进行分析.[结果]低、中及高危组年龄、BMI、CRP、纤维蛋白原、D-D、NT-ProBNP、MHR及SII间差异均有统计学意义(P<0.05).MHR、SII及MHR+SII预测APE病情严重程度的ROC曲线中MHR+SII曲线下面积最大;院内生存组与死亡组年龄、HDL-C、CRP、D-D、NT-ProBNP、MHR及SII间差异均有统计学意义(P<0.05).二元Logistic回归分析结果显示,D-D、MHR及SII是APE患者院内死亡的危险因素(P<0.05).预测APE患者院内死亡情况的ROC曲线分析结果显示,MHR+SII时受试者工作曲线下面积最大.MHR、SII与D-D存在线性关系,MHR(r=0.285,P<0.01)和SI(I r=0.219,P<0.05)与D-D均呈正相关.[结论]MHR、SII与APE患者病情严重程度及院内死亡情况具有相关性,可用于评估APE患者的病情严重程度及预测院内死亡情况,且两者联合应用预测价值更高.
OBJECTIVE To research the predictive value of monocyte to high-density lipoprotein ratio(MHR)and systemic immune-inflammation index(SII)for the disease and in-hospital death of patients with acute pulmonary embolism(APE).METHODS A total of 164 patients diagnosed with APE by selective pulmonary angiography from March 2016 to May 2022 were selected.Basic data of all patients were collected,and all patients were divided into three groups according to PESI scoring criteria:lowrisk group(n=38),medium-risk group(n=84),and high-risk group(n=42).The patients were divided into two groups according to their survival in hospital:survival group(n=138)and death group(n=26).General clinical data such as age,gender,height,weight,and laboratory indicators such as blood routine,D-D,NT-ProBNP,CRP,blood lipid and coagulation time of the selected patients were collected,and MHR,SII were calculated for analysis.RESULTS There were significant differences in ages,BMI,CRP,fibrinogen,D-D,NT-ProBNP,MHR,SII in the low-risk group,medium-risk group and high-risk group(P<0.05).The ROC curve of MHR,SII and MHR+SII predicted the severity of acute pulmonary embolism,and the area under MHR+SII curve was the largest.The differences of ages,HDL-C,CRP,D-D,NT-ProBNP,MHR,SII of the survival group and the death group were statistically significant(P<0.05).Binary Logistics regression analysis showed that D-D,MHR and SII were all risk factors for hospital death in APE patients(P<0.05).In the ROC curve for predicting in-hospital death of APE patients,MHR+SII had the largest area under the receiver operating curve.There is a linear relationship between MHR,SII and D-D,MHR and D-D are positively correlated(r=0.285,P<0.01),SII and D-D are positively correlated(r=0.219,P<0.05).CONCLUSION MHR and SII were correlated with the severity of disease and inhospital death of APE patients,which could provide an important basis for assessing the severity of disease and predicting in-hospital death of APE patients,and the combination of MHR and SII had a higher predictive value.
作者
臧传丽
朴玉华
朴红梅
ZANG Chuanli;PIAO Yuhua;PIAO Hongmei(Affiliated Hospital of Yanbian University,Yanji 133000,Jilin,China)
出处
《延边大学医学学报》
CAS
2023年第4期276-281,共6页
Journal of Medical Science Yanbian University
关键词
急性肺栓塞
炎症指标
单核细胞计数
高密度脂蛋白胆固醇
系统免疫炎症指数
acute pulmonary embolism
inflammation indicators
monocyte coun
high density lipoprotein cholesterol
systemic immune-inflammation index
