[1]赵贺红,李 群.不同病情严重程度急性肺栓塞患者血清和肽素、白细胞介素-38、单核细胞计数/高密度脂蛋白胆固醇、D-二聚体/纤维蛋白原变化及预后影响因素分析[J].陕西医学杂志,2023,52(9):1186-1190.[doi:DOI:10.3969/j.issn.1000-7377.2023.09.016]
 ZHAO Hehong,LI Qun.Changes of serum copeptin,interleukin-38,monocyte to high-density lipoprotein ratio,D-dimer to fibrinogen ratio and prognostic factors in patients with acute pulmonary embolism of different severity[J].,2023,52(9):1186-1190.[doi:DOI:10.3969/j.issn.1000-7377.2023.09.016]
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不同病情严重程度急性肺栓塞患者血清和肽素、白细胞介素-38、单核细胞计数/高密度脂蛋白胆固醇、D-二聚体/纤维蛋白原变化及预后影响因素分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年9期
页码:
1186-1190
栏目:
临床研究
出版日期:
2023-09-05

文章信息/Info

Title:
Changes of serum copeptin,interleukin-38,monocyte to high-density lipoprotein ratio,D-dimer to fibrinogen ratio and prognostic factors in patients with acute pulmonary embolism of different severity
作者:
赵贺红李 群
(西南交通大学附属医院 成都市第三人民医院呼吸与危重症医学科,四川 成都 610031)
Author(s):
ZHAO HehongLI Qun
(Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Southwest Jiaotong University,Chengdu 610031,China)
关键词:
急性肺栓塞 和肽素 白细胞介素-38 单核细胞/高密度脂蛋白胆固醇 D-二聚体/纤维蛋白原 疾病严重程度 预后
Keywords:
Acute pulmonary embolism Copeptin Interleukin-38 Monocyte to high-density lipoprotein cholesterol ratio D-dimer to fibrinogen ratio Severity of the disease Prognosis
分类号:
R 563.5
DOI:
DOI:10.3969/j.issn.1000-7377.2023.09.016
文献标志码:
A
摘要:
目的:探讨不同病情严重程度急性肺栓塞(APE)患者血清和肽素、白细胞介素-38(IL-38)、单核细胞计数/高密度脂蛋白胆固醇(MHR)、D-二聚体/纤维蛋白原(DFR)的变化,分析患者预后影响因素。方法:选取APE患者80例,根据病情严重程度不同分为低危组(35例)、中危组(28例)和高危组(17例)。另选取同期体检健康者50例为对照组。比较各组血清和肽素、IL-38、MHR、DFR水平。采用肯德尔秩相关分析血清和肽素、IL-38、MHR、DFR水平与疾病严重程度的相关性。根据预后情况将APE患者分为生存组(66例)和病死组(14例),分析APE患者预后的影响因素。结果:与对照组比较,低、中、高危组血清和肽素、MHR、DFR水平升高,IL-38水平降低(均P<0.05)。中、高危组血清和肽素、MHR、DFR水平高于低危组,且高危组高于中危组(均P<0.05)。中、高危组IL-38水平低于低危组,且高危组低于中危组(均P<0.05)。和肽素与APE患者病情严重程度呈正相关(r=0.230,P=0.009),IL-38、MHR、DFR水平与病情严重程度无关(均P>0.05)。病情严重程度(高危)、BNP>100 pmol/L、cTnT>0.2 μg/L、和肽素、MHR、DFR为APE患者预后的独立危险因素,IL-38则是独立保护因素(均P<0.05)。结论:APE患者血清和肽素、MHR、DFR水平随病情加重而升高,IL-38水平随病情加重而降低。病情严重程度、BNP、cTnT、和肽素、IL-38、MHR、DFR为APE患者预后的独立影响因素。
Abstract:
Objective:To investigate the changes of serum copeptin,interleukin-38(IL-38),monocyte to high-density lipoprotein cholesterol ratio(MHR),and D-dimer to fibrinogen ratio(DFR)in patients with acute pulmonary embolism(APE)of different severity,and to analyze the prognostic factors of patients.Methods:According to the severity of the disease,80 patients with APE were divided into low-risk group(35 cases),medium-risk group(28 cases)and high-risk group(17 cases).Another 50 healthy people were selected as the control group.The levels of serum copeptin,IL-38,MHR and DFR in each group were compared.Kendall rank correlation was used to analyze the correlation between serum copeptin,IL-38,MHR,DFR levels and the severity of the disease.According to the prognosis,the APE patients were divided into survival group(66 cases)and death group(14 cases),and the prognostic factors of APE patients were analyzed.Results:Compared with the control group,the levels of serum copeptin,MHR and DFR in the low-,medium- and high-risk groups were increased,and the level of IL-38 was decreased(all P<0.05).The levels of serum copeptin,MHR and DFR in the medium- and high-risk groups were higher than those in the low-risk group,and those in the high-risk group were higher than those in the medium-risk group(all P<0.05).The level of IL-38 in the medium- and high-risk groups was lower than that in the low-risk group,and the high-risk group was lower than that in the medium-risk group(all P<0.05).Copeptin was positively correlated with the severity of APE patients(r=0.230,P=0.009),while IL-38,MHR and DFR levels were not correlated with the severity of APE patients(all P>0.05).The severity of disease(high-risk),BNP >100 pmol/L,cTnT >0.2 μg/L,copeptin,MHR and DFR were independent risk factors for the prognosis of APE patients,and IL-38 was an independent protective factor(all P<0.05).Conclusion:The levels of serum copeptin,MHR and DFR in patients with APE increase with the aggravation of the disease,while the level of IL-38 decreases.The severity of the disease,BNP,cTnT,copeptin,IL-38,MHR and DFR are independent influencing factors for the prognosis of APE patients.

参考文献/References:

[1] Yandrapalli S,Tariq S,Kumar J,et al.Chronic thromboembolic pulmonary hypertension:Epidemiology,diagnosis,and management[J].Cardiol Rev,2018,26(2):62-72.
[2] 姚海珍,冯 亮,解 娟,等.补肺强心方治疗慢性血栓栓塞性肺动脉高压疗效研究[J].陕西中医,2022,43(12):1713-1716.
[3] 徐 璨,赵 敏.和肽素在急诊科危急重症中的应用[J].中国实用内科杂志,2019,39(7):656-659.
[4] 郭 北,郝建东,赵芸芳,等.血清IL-38、miR-1233水平对中晚期肺癌化疗后近期发生肺栓塞风险的预估价值[J].临床肺科杂志,2022,27(11):1718-1723.
[5] Jiang M,Yang J,Zou H,et al.Monocyte-to-high-density lipoprotein-cholesterol ratio(MHR)and the risk of all-cause and cardiovascular mortality:A nationwide cohort study in the United States[J].Lipids Health Dis,2022,21(1):30.
[6] 宫莉莉,蒋广恩,甘利萍.红细胞分布宽度联合D-二聚体及D-二聚体与纤维蛋白原比值对老年静脉血栓栓塞症的诊断价值[J].中国实用乡村医生杂志,2021,28(9):58-61.
[7] Wyzgai A,Koc M,Pacho S,et al.Plasma copeptin for short term risk stratification in acute pulmonary embolism[J].J Thromb Thrombolysis,2016,41(4):563-568.
[8] 中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组.肺血栓栓塞症诊治与预防指南[J].中华医学杂志,2018,98(14):1060-1087.
[9] 中华医学会心血管病学分会肺血管病学组.急性肺栓塞诊断与治疗中国专家共识(2015)[J].中华心血管病杂志,2016,44(3):197-211.
[10] 赵新春,张 翔.利伐沙班治疗急性肺血栓栓塞疗效及对患者血生化指标、右心室功能的影响研究[J].陕西医学杂志,2020,49(7):874-877,880.
[11] 米玉红.急性肺血栓栓塞症的诊断与治疗规范及面临的问题[J].中国急救医学,2017,37(1):17-22.
[12] 黄玉芳,龙 瀛,欧国春,等.IMA、IL-38、DFR水平与急性肺栓塞患者危险分层和预后的相关性[J].中南医学科学杂志,2022,50(2):219-222.
[13] 朱亚茜,马淑萍,董维刚,等.血清白细胞介素38与慢性阻塞性肺疾病急性加重合并肺栓塞的相关性[J].中华医学杂志,2019,99(12):929-933.
[14] 田丁元,党连生.MIP-1α、DFR对老年卧床静脉血栓栓塞症的预测价值[J].天津医药,2019,47(9):966-970.
[15] 陈 洋,范存存,王锦坤.合肽素、同型半胱氨酸及心肌型脂肪酸结合蛋白检测在急性肺栓塞病情评估中的应用分析[J].实用医院临床杂志,2023,20(1):56-58.
[16] 陈安琪,蒋 鹏,吴 云.MHR在评估常见心血管疾病中的研究进展[J].内蒙古医学杂志,2022,54(6):710-712,717.
[17] 罗 祥,宋 韵,郭春丽,等.局部灌注瑞替普酶溶栓在高危肺动脉栓塞患者行经肺动脉内导管碎栓介入治疗中的效果与安全性研究[J].陕西医学杂志,2019,48(2):266-269.
[18] 陈 娜,杨军辉,刘 玲.补肺化瘀通络汤联合阿替普酶治疗慢性肺栓塞疗效研究[J].陕西中医,2021,42(12):1688-1691.
[19] 李亚珍,傅应云,穆雪鹍.影响急性肺栓塞预后的相关因素分析[J].南京医科大学学报:自然科学版,2016,36(11):1368-1372.
[20] 周道祥,丘卫恩,周淑英.血浆BNP预测急性肺栓塞患者发生心血管疾病的临床研究[J].广州医药,2019,50(2):20-23.
[21] 庞颖颖,刘海涛.生物标志物与急性肺栓塞危险分层及预后的关联性研究[J].中华全科医学,2022,20(2):199-201,281.
[22] 徐唯傑,马 俊,李明才.IL-38的生物学特性及其在肺部疾病中作用的研究进展[J].中国病理生理杂志,2020,36(9):1715-1720.
[23] 王少飞,郑洪飞,李金玲,等.不同危险分层急性肺栓塞患者D-二聚体与纤维蛋白原比值、中性粒细胞与淋巴细胞比值、白蛋白的变化及其与预后的关系研究[J].现代生物医学进展,2022,22(24):4758-4762.

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备注/Memo

备注/Memo:
基金项目:四川省医学会科研课题(2021HR78)
更新日期/Last Update: 2023-09-04