血脂水平对sPESI评分为高危的急性肺动脉栓塞患者的预测作用

Predictive effect by blood fat level for acute pulmonary embolism with high risk s PESI score

目的探讨在急性肺动脉栓塞患者中血脂水平和简化急性肺栓塞严重程度指数(s PESI)评分不同危险分层之间的关系。方法 94例肺栓塞患者,使用s PESI评分将患者分为高危组34例(s PESI评分≥1分)与低危组60例(s PESI评分=0分),使用Logistic回归分析高危患者的独立预测因子。结果 s PESI评分高危组血清总胆固醇水平为(3.7±0.8)mmol/L、高密度脂蛋白胆固醇水平为(1.2±0.5)mmol/L,低于低危组的(4.3±1.1)mmol/L、(1.9±0.3)mmol/L(P<0.05),高危组右室直径为(3.5±0.3)cm,大于低危组的(2.9±0.5)cm(P<0.05)。Logistic回归分析总胆固醇[OR=1.095,95%CI=(1.021,1.175),P<0.05]、高密度脂蛋白胆固醇[OR=1.428,95%CI=(1.107,1.842),P<0.05]、右室直径[OR=11.31,95%CI=(3.25,52.64),P<0.05]为高危患者的独立预测因子。结论血清总胆固醇、高密度脂蛋白胆固醇可以作为s PESI评分为高危急性肺动脉栓塞患者独立预测因子。

Objective To investigate relationship between blood fat level and different simplified pulmonary embolism severity index（s PESI） risk stratification in acute pulmonary embolism patients. Methods A total of 94 patients with pulmonary embolism as study subjects were divided by their s PESI scores into high risk group with 34 cases（s PESI score ≥ 1 points） and low risk group with 60 cases（s PESI score=0 points）. Logistic regression analysis was applied to analyze independent predictive factors in high risk patients. Results High risk group had serum total cholesterol level as（3.7±0.8） mmol/L and high-density lipoprotein cholesterol level as（1.2±0.5） mmol/L, which were lower than（4.3±1.1） and（1.9±0.3） mmol/L in low risk group（P〈0.05）. High risk group had wider right ventricular dimension as（3.5±0.3）cm than（2.9±0.5）cm in low risk group（P〈0.05）. Logistic regression analysis showed total cholesterol [OR=1.095, 95%CI=（1.021, 1.175）, P〈0.05], high-density lipoprotein cholesterol [OR=1.428, 95%CI=（1.107, 1.842）, P〈0.05] and right ventricular dimension [OR=11.31, 95%CI=（3.25, 52.64）, P〈0.05] as independent predictive factors in high risk patients. Conclusion Serum total cholesterol and high-density lipoprotein cholesterol act as independent predictive factors in acute pulmonary embolism patients with high risk s PESI score.