Diagnostic Value of Serum ADAM15,GRP78 Combined with CT Pulmonary Angiography for Acute Pulmonary Embolism
Objective To investigate the diagnostic value of serum a disintegrin and metalloprotease 15(ADAM15)and glucose regulated protein 78(GRP78)combined with CT pulmonary angiography(CTPA)for acute pulmonary embolism(APE).Methods From June 2021 to June 2023,86 suspected APE patients who visited our hospital were collected,and all patients underwent CTPA examination,APE patients were divided into medium-high-risk and low-risk groups according to the severity of the disease;enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of ADAM15 and GRP78;Pearson's correlation analysis was used to analyse the correlation between serum ADAM15,GRP78 and CTPA indexes;multifactorial logistic regression analysis was used to analyse the influencing factors of medium-and high-risk APE;and ROC curves were plotted to analyse the diagnostic value of serum The diagnostic value of ADAM15 and GRP78 for intermediate-and high-risk APE.Results After CTPA,702 emboli were detected in 86 patients,and 86 patients showed filling defects in different pulmonary artery sites,etc.The lesion sites were mainly located in both lungs in 29 cases,in the left lung in 30 cases,and in the right lung in 27 cases.4 types of emboli were found in 42 cases of the central type,in 98 cases of the eccentric type,in 26 cases of the adnexal thrombus type,and in 30 cases of the complete occlusion type.RVD/LVD,RV-LD/LV-LD,and Qanadli embolic index were significantly higher in the intermediate-and high-risk group than in the low-risk group(P＜0.05).Serum ADAM15 and GRP78 levels were significantly higher in the intermediate-and high-risk group than in the low-risk group(P＜0.05).According to Pearson's correlation analysis,serum ADAM15 was positively correlated with GRP78(P＜0.05),and both were positively correlated with RVD/LVD,RV-LD/LV-LD,and Qanadli embolic index(P＜0.05).Multifactorial logistic regression analysis informed that ADAM15,GRP78,RVD/LVD,RV-LD/LV-LD,and Qanadli embolic index were risk factors affecting intermediate-and high-risk APE patients(P＜0.05).According to the ROC curve,the AUC of the combination of serum ADAM 15,GRP78,RVD/LVD,RV-LD/LV-LD,and Qanadli embolic index for the diagnosis of intermediate-to high-risk APE was 0.990,and the combination of the five was superior to their respective individual diagnoses(ZcombinedvsADAM15=2.691,Zcombined vs GRP78=2.578,Zcombined vs RVD/LVD=2.710,Zcombined vs RV-LD/LV-LD=2.714,and Zcombined vs Qanadli embolic index=2.698,all P＜0.05).Conclusion Serum ADAM15 and GRP78 are significantly elevated in patients with APE,and their combination with CTPA may improve the diagnostic value of APE.
A Disintegrin and Metalloprotease 15Glucose Regulated Protein 78CT Pulmonary AngiographyAcute Pulmonary EmbolismDiagnosis
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