摘要
目的探讨纤维蛋白原(FIB)、红细胞分布宽度(RDW)、极低密度脂蛋白(VLDL)对高海拔地区肺栓塞(PE)的诊断价值。方法选取2017年1月至2023年6月在西藏自治区人民政府驻成都办事处医院呼吸内科确诊的高海拔地区的PE患者57例设为PE组,另选取同期在本院体检且一般资料与PE组匹配的高海拔地区健康者83例为非PE组。收集两组的人口学特征、临床资料和实验室指标。采用多因素Logistic回归分析筛选高海拔地区PE发生的独立危险因素;应用受试者工作特征曲线的曲线下面积(AUC)评估诊断效能;独立预测因素AUC间的比较使用DeLong检验。结果与非PE组相比,PE组的FIB、RDW和VLDL明显升高(P<0.05);FIB(OR:1.678,95%CI:1.224~2.299)、RDW(OR:1.042,95%CI:1.002~1.084)和VLDL(OR:8.575,95%CI:1.681~43.746)与高海拔地区PE的发生有关(P<0.05);由FIB、RDW和VLDL构建的组合模型,其AUC(0.791)明显高于FIB(0.707)、RDW(0.663)和VLDL(0.691),差异有统计学意义(P<0.05)。结论FIB、RDW和VLDL均为发生高海拔地区PE的独立危险因素,由FIB、RDW和VLDL构建的组合模型具有较高的诊断效能。
Objective To evaluate the diagnostic value of fibrinogen(FIB),red-blood-cell distribution width(RDW),and very low density lipoprotein(VLDL)for pulmonary embolism(PE)in high attitude areas.Methods A total of 57 patients with PE in high altitude areas who were diagnosed by the Department of Respiratory Medicine in the Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from January 2017 to June 2023 were selected as the PE group,and 83 healthy people in high altitude areas who underwent physical examination in the same hospital during the same period and whose general data were matched with the PE group were selected as the non-PE group.Demographic characteristics,clinical data,and laboratory indicators of the two groups were collected.Multivariate Logistic regression analysis was used to determine the independent risk factors for PE in high altitude areas.The area under curve(AUC)of receiver operating characteristic curve was used to assess the diagnostic performance.The AUCs of independent predictive factors were compared using Delong test.Results The PE group showed significantly higher FIB,RDW,and VLDL than non-PE group(P<0.05).FIB(OR:1.678,95%CI:1.224-2.299),RDW(OR:1.042,95%CI:1.002-1.084),and VLDL(OR:8.575,95%CI:1.681-43.746)were significantly associated with the occurrence of PE in high altitude areas(P<0.05).The combined model comprising FIB,RDW,and VLDL had significantly higher AUC(0.791)than FIB(0.707),RDW(0.663),and VLDL(0.691),and the differences were statistically significant(P<0.05).Conclusion FIB,RDW and VLDL are independent risk factors for PE in high altitude areas.The combined model comprising FIB,RDW,and VLDL has high diagnostic performance for PE in high altitude areas.
作者
张作英
冯霞
贾玉梅
陈梅
Zhang Zuoying;Feng Xia;Jia Yumei;Chen Mei(North Sichuan Medical College,Nanchong 637000,China;Department of Intensive Care Unit,Hospital of Chengdu Office of People's Government of Tibet Autonomous Region,Chengdu 610041,China;Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)
出处
《成都医学院学报》
CAS
2024年第1期89-93,共5页
Journal of Chengdu Medical College
基金
四川省医学会专项科研课题(No:2019HR43)
成都中医药大学“杏林学者”学科人才科研提升计划项目(No:ZYTS2023026)。
关键词
纤维蛋白原
红细胞分布宽度
极低密度脂蛋白
高海拔
肺栓塞
Fibrinogen
Red-blood-cell distribution width
Very low density lipoprotein
High attitude
Pulmonary embolism
