摘要
目的探讨血浆游离线粒体DNA(mtDNA)水平在急性肺栓塞(APE)中的诊断价值及其与病情严重程度和临床常用指标的相关性。方法选取2021年3月至2022年12月山西医科大学第一医院呼吸与危重症医学科收治的90例首次经CT肺动脉造影(CTPA)确诊的APE患者为研究对象,分为高危组、中危组、低危组,每组30例,选择同期年龄相似的健康体检者30例作为健康组。记录所有研究对象一般资料,采集所有研究对象入院第1天未经治疗的血浆和全血标本,对其进行血常规、D-二聚体(D-D)、纤维蛋白(原)降解产物(FDP)、心肌肌钙蛋白T(cTnT)、N末端脑钠肽前体(NT-proBNP)等指标检测;提取上述所有受试者血浆游离mtDNA,应用实时荧光定量聚合酶链反应标准曲线法检测血浆游离mtDNA水平,比较各组mtDNA及其他临床常用指标,并分析mtDNA与其他临床常用指标的相关性;使用受试者工作特征(ROC)曲线评价血浆游离mtDNA和其他临床常用指标对APE的诊断价值。结果健康组、低危组、中危组、高危组血浆游离mtDNA水平分别为272(199)、813(529)、2983(3327)和10097(6889)copies/mL,mtDNA水平在高危组、中危组、低危组和健康组中依次降低,两两比较,差异均有统计学意义(P<0.05)。APE患者血浆游离mtDNA水平与白细胞计数(WBC)、D-D、FDP、cTnT、NT-proBNP呈正相关(r=0.304、0.446、0.532、0.673、0.666,P<0.05);与RBC、血红蛋白(Hb)、红细胞体积分布宽度(RDW)、血小板计数(PLT)无相关关系(P>0.05);mtDNA诊断APE的ROC曲线下面积为0.995,灵敏度为91%,特异度为90%,cut-off值为557 copies/mL。结论APE患者血浆游离mtDNA水平升高,并与疾病危险分层有关;血浆游离mtDNA水平有助于诊断APE,mtDNA也可作为预测APE病情严重程度的一种标志物。
Objective To investigate the diagnostic value of plasma free mitochondrial DNA(mtDNA)in acute pulmonary embolism(APE)and its correlation with the severity of the disease and common clinical indicators.Methods A total of 90 patients with APE diagnosed for the first time by CT pulmonary arteriography(CTPA)in the Department of Respiratory and Critical Care Medicine of the First Hospital of Shanxi Medical University from March 2021 to December 2022 were selected as the study subjects,including high-risk group,medium-risk group and low-risk group,with 30 cases in each group.A total of 30 healthy subjects of similar age were selected as the healthy group.General data of all subjects were recorded,untreated plasma and whole blood samples were collected from all subjects on the first day of admission,and blood routine,D-dimer(D-D),fibrin degradation product(FDP),cardiac troponin T(cTnT),N-terminal brain natriuretic peptide precursor(NT-proBNP)were detected.Plasma free mtDNA was extracted from all the above subjects,and the plasma free mtDNA level was detected by real-time fluorescence quantitative polymerase chain reaction standard curve method,the mtDNA and other common clinical indicators were compared in different group,the correlations between other common clinical indicators and mtDNA were analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of plasma free mtDNA and other common clinical indicators in APE.Results Plasma free mtDNA levels in healthy group,low-risk group,medium-risk group and high-risk group were 272(199),813(529),2983(3327)and 10097(6889)copies/mL respectively.The levels of mtDNA were successively decreased in high-risk group,medium-risk group,low-risk group and healthy group,the differences were statistically significant(P<0.05).The levels of plasma free mtDNA in APE patients correlated positively with WBC,D-D,FDP,cTnT,NT-proBNP(r=0.304,0.446,0.532,0.673,0.666,P<0.05),there was no correlation with RBC,Hb,RDW and PLT(P>0.05).The area under ROC curve for mtDNA diagnosis of APE was 0.995,the sensitivity was 91%,the specificity was 90%,and the cut-off value was 557 copies/mL.Conclusion The level of plasma free mtDNA increases in APE patients and correlated with the severity of disease risk stratification.The level of free mtDNA in plasma is helpful for the diagnosis of APE and mtDNA can also be used as a marker to predict the severity of APE.
作者
谭娇娜
杨泽华
TAN Jiaona;YANG Zehua(The First Clinical Medical College of Shanxi Medical University,Taiyuan,Shanxi 030001,China;Department of Clinical Laboratory,the First Hospital of Shanxi Medical University,Taiyuan,Shaanxi 030001,China)
出处
《检验医学与临床》
CAS
2023年第16期2355-2360,共6页
Laboratory Medicine and Clinic
关键词
线粒体DNA
急性肺栓塞
疾病危险分层
mitochondrial DNA
acute pulmonary embolism
disease risk stratification
