摘要
目的：探讨心肌型脂肪酸结合蛋白（H-FABP ）联合血浆 D-二聚体在评价急性肺栓塞（APE）患者预后中的临床价值。方法选取本院2011年1月至2014年12月确诊的APE患者120例为研究对象，采用酶联免疫吸附法分别测定外周血H-FABP及D-二聚体浓度。根据病情严重程度将APE患者分为低危组、中危组及高危组；根据临床转归，分为存活组和死亡组，比较不同组间H-FABP和D-二聚体差异，评价H-FABP和D-二聚体对评估APE患者预后的临床价值。结果随着APE患者病情严重程度的增加，H-FABP和D-二聚体指标水平显著升高（P＜0.05）；死亡组H-FABP和D-二聚体水平显著高于存活组（P＜0.05）。相关性分析显示，血浆H-FABP与D-二聚体水平呈正相关（r=0.693，P=0.000）。ROC曲线分析显示，H-FABP曲线下面积为0.845（95%CI：0.752～0.918），其最佳工作点为8.65μg/L，此时诊断APE的敏感性为81.24%，特异性为84.14%；D-二聚体曲线下面积为0.832（95%CI：0.728～0.899），其最佳工作点为1.25 mg/L，此时诊断APE的敏感性为83.72%，特异性为82.65%。结论 H-FABP联合D-二聚体可有效的评估APE患者病情严重程度及预后，可为临床APE患者个体化治疗，降低其死亡率提供客观依据。
ObjectiveTo evaluate the clinical value of heart-type fatty acid-binding protein （H-FABP） and D-dimer in assessing the prognosis of acute pulmonary embolism （APE）. MethodsTotaly 120 APE patients were hospitalized from January 2011 to December 2014 and enroled in this study. The plasma H-FABP and D-dimer level were measured by enzyme-linked immunosorbent assay. The APE patients were divided three groups including low-risk, middle-risk and high-risk group by European heart association new guidelines. According to the clinical prognosis, the APE patients were divided into survival and death group. The H-FABP and D-dimer level in different groups and the relationship with the prognosis were assessed.ResultsWith the increased severity in patients, the H-FABP and D-dimer level were significantly elevated （P〈0.05）; the H-FABP and D-dimer level were significantly higher in death group as compared with survival group （P〈0.05）. The H-FABP and D-dimer level were positively correlated （r=0.693,P=0.000）. ROC curves analysis results showed that the area under curve of H-FABP was 0.845 （95%CI： 0.752-0.918）, and optimal operating point （OOP） was 8.65 μg/L, which had 81.24% sensitivity and 84.14% specificity; ACU of D-dimer was 0.832 （95%CI： 0.728-0.899）, and OOP was 1.25 mg/L, which had 83.72% sensitivity and 82.65% specificity.Conclusion The H-FABP and D-dimer can effectively assess severity and prognosis of APE patients, meanwhile, it provide an objective basis for the clinical individual treatment and reducing the mortality rate of APE patients.
出处
《中华临床医师杂志（电子版）》
CAS
2015年第15期48-51,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
脂肪酸结合蛋白质类
嘧啶二聚物
肺栓塞
预后
Fatty acid-binding proteins
Pyrimidine dimers
Pulmonary embolism
Prognosis
