生物标志物在急性肺血栓栓塞症肺动脉高压早期临床评估价值OA

Objective:This study investigated the changes in serum platelet/lymphocyte ratio(PLR),D-dimer,and N-terminal pro-B-type natriuretic peptide(NT-BNP)in patients with acute pulmonary embolic pulmonary hypertension(APTE-PH),and explored their clinical significance in the early diagnosis of this disease.Method:A total of 98 patients with acute pulmonary thromboembolism(APTE)were included.Blood samples were collected immediately after admission to determine blood routine,D-dimer,NT-BNP,and other examinations.PLR was calculated,and its relationship with APTE-PH was analyzed.Echocardiography was completed within 24 hours after admission to measure pulmonary artery systolic pressure(PASP).The patients were divided into the pulmonary arterial hypertension group(PH group)and the normal pulmonary artery pressure group(non-PH group).The levels of PLR,D-dimer,and NT-BNP in the two groups were compared,and the occurrence of major adverse events during hospitalization and within 3 months after discharge in the two groups was recorded.The predictive value of PLR,D-dimer,and NT-BNP for APTE-PH was evaluated by using the receiver operating characteristic curve(ROC).Result:The values of NT-BNP and pulmonary arterial hypertension in the PH group were significantly higher than those in the non-PH group.The age of the PH group was significantly higher than that of the non-PH group.Moreover,when comparing the clinical manifestations(chest pain,hemoptysis,dyspnea)between the two groups,the differences were statistically significant(P<0.05).There was no statistically significant difference in PLR,D-dimer and the incidence of adverse events within 3 months between the two groups(P>0.05).The area under the curve(AUC)of NT-BNP in the diagnosis of APTE-PH was 0.771,with a sensitivity of 76.6％and a specificity of 74.5％,which was significantly better than that of PLR and D-dimer.Conclusion:The combination of multiple biomarkers can improve the accuracy of diagnosing APTE-PH to a certain extent.NT-BNP is significantly elevated in patients with APTE-PH and has higher diagnostic value,which can be used as a potential biomarker for the early identification of APTE-PH.