D-二聚体与DFR、NT-proBNP联合APACHEⅡ评分对急性肺栓塞患者短期预后的预测价值OA

Objective To explore the predictive value of D-dimer-to-plasma fibrinogen ratio(DFR),N-terminal pro-brain natriuretic peptide(NT-proBNP)combined with acute physiology and chronic health eval-uationⅡ(APACHEⅡ)score on the short-term prognosis of acute pulmonary embolism(APE).Methods A retrospective analysis was conducted,selecting the clinical data of 181 APE patients diagnosed in our hospital from January 2019 to December 2024.The general information,DFR,NT-proBNP,APACHEⅡ score,and simplified pulmonary embolism severity index(sPESI)score of the two groups of patients were compared.The predictive value of DFR,NT-proBNP,APACHEⅡ score,sPESI score,and the combination of the former three for the prognosis of APE patients was evaluated.A binary logistic regression was used to construct a prognostic model.The predictive efficacy was analyzed using the receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results Among the 181 APE patients,137 survived during the 30-day follow-up period(included in the survival group),and 44 died(included in the death group).The heart rate,prothrombin time,international normalized ratio,D-dimer,plasma fibrinogen,DFR,NT-proBNP,troponin,A-PACHEⅡ score,and sPESI score in the death group were higher than those in the survival group,while sys-tolic blood pressure,diastolic blood pressure,mean arterial pressure,and SaO2 were lower than those in the survival group.All these differences were statistically significant(P<0.05).The combination of DFR,NT-proBNP and APACHEⅡ score could be included in the prediction model,and all were independent influencing factors for all-cause mortality within 30 days for APE patients(P<0.05).The results of ROC curve analy-sis showed that the combined prediction of DFR,NT-proBNP and APACHEⅡ score had an AUC of 0.856(95%CI:0.788-0.925),and its predictive value was higher than that of sPESI score(AUC=0.737,95%CI:0.636-0.838).Conclusion It is suggested that DFR,NT-proBNP and APACHEⅡ scores should be included together in the early disease assessment system for APE patients,providing a more reliable basis for the early formulation of individualized treatment plans.