Correlation between serum levels of APJ endogenous ligand 13,growth differentiation factor 15,and glucose regulatory protein 78 in patients with acute pulmonary embolism and clinical prognosis
Objective To investigate the predictive value of serum APJ endogenous ligand 13(Apelin-13),growth differen-tiation factor 15(GDF-15),and glucose regulatory protein 78(GRP78)levels in patients with acute pulmonary embolism for clinical prognosis.Methods A total of 86 patients with acute pulmonary embolism admitted to the People's Hospital of Yucheng County from February 1,2020 to April 30,2022 were selected as the research subjects.Based on the progno-sis within 30 days after discharge,these patients were divided into a poor prognosis group of 25 cases and a good progno-sis group of 61 cases.The baseline data of two groups of patients,the serum levels of Apelin-13,GDF-15,and GRP78 in patients of different groups and severity of the disease were compared.The correlation of various serum indicators with clinical indicators[partial pressure of oxygen(PO2),partial pressure of carbon dioxide(PCO2),pH value,pulmonary embolism severity index(PESI)score,global registry of acute coronary events(GRACE)score,fibrinogen(FBG),right ventricular diastolic end diameter(RVED),left ventricular end diastolic diameter(LVED)],and severity of the condition were analyzed.The predictive value of serum indicators on prognosis was analyzed using the receiver operating character-istic(ROC)curve.Results The PO2 level in the group with poor prognosis was(54.85±5.28)mmHg,which was lower than the(74.16±10.72)mmHg in the good prognosis group,t=8.569,P＜0.001;the PCO2 level was(39.86±3.21)mmHg,which was lower than the(41.96±4.18)mmHg in the good prognosis group,t=2.252,P=0.027;the PESI score was 126.38±20.12,which was higher than the 84.26±15.08 of the good prognosis group,t=10.636,P＜0.001;the GRACE score was 122.68±20.81,which was higher than 86.31±18.77 of the good prognosis group,t=7.905,P＜0.001;the FBG level was(5.93±1.17)％,which was higher than(3.40±0.65)％in the good prognosis group,t=12.799,P＜0.001;the RVED level was(78.15±10.05)mm,which was higher than the(45.32±9.16)mm of the good prognosis group,t=14.671,P＜0.001;the LVED level was(35.26±8.75)mm,which was higher than(26.37± 6.19)mm of the good prognosis group,t=5.335,P＜0.001.On the 7th day after discharge,the serum levels of Apelin-13,GDF-15,and GRP78 in both groups of patients were lower than those at admission,and the serum levels of Apelin-13,GDF-15,and GRP78 in the poor prognosis group were(62.38±10.79)ng/ml,(543.21±113.12)ng/L,and(2.52±0.35)μg/L,respectively,which were higher than those of the good prognosis group[(50.06±9.68)ng/ml,(419.67±99.89)ng/L,and(1.63±0.24)μg/L],and the differences were statistically significant,with F values of 37.268,24.338,and 42.751,all P＜0.001.Comparison of serum Apelin-13,GDF-15,and GRP78 levels at admission a-mong patients with different severity of illness:mild obstruction＜moderate obstruction＜severe obstruction,all P＜0.001.The serum levels of Apelin-13,GDF-15,and GRP78 at admission were positively correlated with the PESI score,GRACE score,FBG,RVED,LVED,and severity of the condition(P＜0.05).The AUC predicted by the combination of various serum indicators on the 7th day after discharge in patients with acute pulmonary embolism was greater than that predicted by individual indicators,P＜0.001.Conclusion The elevated levels of serum Apelin-13,GDF-15,and GRP78 in patients with acute pulmonary embolism are closely related to the progression of the disease.Combined detection of their levels has clinical application value in predicting prognosis.
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