急性肺栓塞患者血清Apelin-13、Copeptin及D-D水平与疾病严重程度和预后的相关性研究

Study on the correlation of the expression of Apelin-13, Copeptin and D-D in serum with the severity of disease deterioration and prognosis in patients with acute pulmonary embolism

目的研究急性肺栓塞患者血清中Apelin-13、合肽素(Copeptin)与D-二聚体(D-dimer,D-D)表达水平并分析其与疾病严重程度和预后的相关性。方法将2013年9月-2018年9月我院收治的183例急性肺栓塞患者定义为观察组,将同期于我院体检的183例健康成年人定为对照组,比较两组患者临床资料、血清Apelin-13、Copeptin与D-D表达水平。将观察组患者按CTPA图像所示阻塞程度进行分级,比较不同分级患者血清Apelin-13、Copeptin与D-D水平,并分析其相关性;统计患者生存及死亡情况,比较不同预后患者血清Apelin-13、Copeptin与D-D水平,并分析其相关性。结果两组性别、年龄、身体质量指数(body mass index,BMI)、胆固醇、甘油三酯、血红蛋白水平无统计学差异(P>0.05);观察组血清Apelin-13、Copeptin与D-D表达水平均高于对照组(P<0.05);观察组中,1、2、3、4级患者例数分别为38、61、54、30例,随着分级的增加,血清Apelin-13、Copeptin与D-D水平也逐渐增加(P<0.05),血清Apelin-13、Copeptin与D-D水平与肺栓塞分级间呈正相关(r=0.349,P=0.021;r=0.422,P=0.036;r=0.534,P=0.009);观察组中21例患者死亡,死亡患者的血清Apelin-13、Copeptin与D-D表达水平高于存活患者(P<0.05),血清Apelin-13、Copeptin与D-D水平与死亡事件的发生呈正相关(r=0.425,P=0.014;r=0.458,P=0.005;r=0.608,P=0.010)。结论患者血清中Apelin-13、Copeptin与D-D水平可作为反映急性肺栓塞患者疾病严重程度和预后的生物学指标,指导临床治疗。

Objective To research the the expression of serum Apelin-13,Copeptin and D-D in patients with acute pulmonary embolism and to find the correlation with the severity of disease deterioration and prognosis.Methods 183 patients with acute pulmonary embolism admitted in our hospital from September 2013 to September 2018 were defined as the observation group,and 183 healthy adults who were examined in our hospital at the same time were defined as the control group.Their clinical data and serum Apelin-13,Copeptin and D-D expression were compared between the two groups.The patients in the observation group were graded according to the degree of obstruction shown in the CTPA images.The serum levels of Apelin-13,Copeptin and D-D in patients with different grades were compared and the correlation was analyzed.The survival and death of patients were analyzed.The serum Apelin-13,Copeptin and D-D levels in patients with different prognosis were compared and the correlation was analyzed.Results There was no significant difference in sex,age,BMI,cholesterol,triglyceride and hemoglobin levels between the two groups(P>0.05).The serum levels of Apelin-13,Copeptin and D-D in the observation group were higher than those in the control group(P<0.05).In the observation group,the number of patients with grade 1,2,3,4 were 38,61,54 and 30,respectively.With the increase of grading,the levels of serum Apelin-13,Copeptin and D-D increased gradually(P<0.05).There was a positive correlation between serum Apelin-13,Copeptin and D-D levels and the grade of pulmonary embolism(r=0.349,P=0.021;r=0.422,P=0.036;r=0.534,P=0.009).The levels of Apelin-13,Copeptin and D-D in serum of 21 dead patients were higher than those of survival patients in the observation group(P<0.05).There was a positive correlation between serum Apelin-13,Copeptin and D-D levels and the occurrence of death events(r=0.425,P=0.014;r=0.458,P=0.005;r=0.608,P=0.010).Conclusion Serum Apelin-13,Copeptin and D-D levels in patients can be used as biological indicators to reflect the severity and prognosis of acute pulmonary embolism and guide clinical treatment.