摘要
目的:探讨血清BNP及D-Dimer/FIB联合简化Wells评分在诊断急性肺栓塞(acute pulmonary embolism,APE)中的价值及与预后的关系.方法:选取张家口市第一医院2022年1月至2022年12月,确诊的154例APE患者为APE组、同期因其他类型肺部疾病等因素住院的患者80例为对照组,对比两组患者的BNP、D-Dimer、FIB、Wells评分,并绘制受试者工作曲线(ROC)分析BNP、D-dImer/FIB联合简化Wells评分诊断APE的价值,根据患者预后结局将APE患者分为生存组和死亡组,采用多元回归模型分析影像患者预后结局的艺因素.结果:APE组患者的BNP、D-Dimer、FIB、D-Dimer/FIB、Wells评分均显著的高于对照组,差异有统计学意义(P＜0.05);BNP、D-Dimer/FIB、Wells评分、BNP+D-DimeR/FIB+Wells评分诊断APE的ROC曲线下面积AUC值分别为0.759、0.855、0.886、0.941;死亡的 APE 患者的 BNP、D-Dimer、FIB、D-Dimer/FIB、Wells 评分均显著的高于存活的APE患者,差异有统计学意义(P＜0.05);Logistic回归结果显示:BNP增高、Wells评分增高、年龄越高、血乳酸越高是APE患者不良预后结局的危险因素(P＜0.05),SaO2越高是APE患者的保护性因素(P＜0.05).结论:BNP+D-Dimer/FIB+Wells评分诊断APE较各项指标单独应用能显著提高诊断价值,BNP增高、Wells评分增高与APE患者不良预后结局有关.
Abstract
Objective:Explore the value of serum BNP D-Dimer/fibrinogen(FIB)combined with simplified Wells score in the diagnosis of acute pulmonary embolism(APE)and its relationship with patient prognosis.Methods:A totla of 154 APE patients diagnosed at Zhangjiakou First Hospital from January 2022 to December 2022 were selected as the APE group,and 80 patients hospitalized due to other types of lung diseases and other factors during the same period were selected as the control group.The BNP,D-Dimer,FIB,and Wells scores of the two groups of patients were compared,and the receiver operating curve(ROC)was drawn to analyze the value of BNP,D-Dimer/FIB combined with simplified Wells scores in diagnosing APE.APE patients were divided into survival and death groups based on patient prognosis.Multiple regression models were used to analyze the relationship between BNP,D-FIB,simplified Wells scores,and patient prognosis.Results:The BNP,D-Dimer,FIB,D-Dimer/FIB,and Wells scores of patients in the APE group were significantly higher than those in the control group,with statistical significance(P＜0.05);The AUC values of the area under the ROC curve for diagnosing APE using BNP,D-Dimer/FIB,Wells score,and BNP+D-Dimer/FIB+Wells score are 0.759,0.855,0.886,and 0.941,respectively;The BNP,D-DImer,FIB,D-Dimer/FIB,and Wells scores of deceased APE patients were significantly higher than those of surviving APE patients,with statistical significance(P＜0.05);The results of the logistic regression model showed that increased BNP,Wells score,age,and blood lactate were independent risk factors for poor prognosis in APE patients(P＜0.05),while higher SaO2 was a protective factor for APE patients(P＜0.05).Conclusions:The BNP+D-Dimer/FIB+Wells score can significantly improve the diagnostic value of APE compared to the use of various indicators alone.An increase in BNP and Wells score is associated with poor prognosis in APE patients.
维普
万方数据