血清载脂蛋白A1在肺栓塞中的临床价值

Clinical value of serum apolipoprotein A1 in pulmonary embolism

目的 探讨血清载脂蛋白A1 (apolipoprotein A1,ApoA1)在肺栓塞中的临床价值。方法 回顾性收集2013年1月至2022年7月宁波市第二医院收治的肺栓塞患者165例纳入肺栓塞组,另选取同期165例健康体检者纳入对照组,收集并比较两组研究对象的一般临床资料,采用Spearman相关分析血清ApoA1与肺栓塞严重指数(pulmonary embolism severity index,PESI)评分的相关性,绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评价血清ApoA1对肺栓塞的诊断价值。结果 肺栓塞组患者的血清ApoA1显著低于对照组(P<0.001)。PESI评分V级患者的血清ApoA1水平显著低于Ⅰ级患者(P<0.05);高危组患者的血清ApoA1水平显著低于低危组(P<0.05);血清ApoA1与PESI评分呈负相关(r=-0.104,P=0.049)。ROC曲线结果 显示,血清ApoA1诊断肺栓塞的曲线下面积为0.932,敏感度为83.03%,特异性为88.48%。结论 肺栓塞患者血清ApoA1显著降低,与肺栓塞的严重程度密切相关;血清ApoA1可作为肺栓塞诊断和预后评估的生物标志物。

Objective To explore the clinical value of serum apolipoprotein A1(ApoA1)in patients with pulmonary embolism.Methods A total of 165 patients with pulmonary embolism admitted to Ningbo No.2 Hospital from January 2013 to July 2022 were retrospectively collected and included in pulmonary embolism group,and another 165 healthy subjects during the same period were selected and included in control group.General clinical data of the two groups were collected and compared.Spearman correlation was used to analyze the correlation between serum ApoA1 and pulmonary embolism severity index(PESI)score.Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of serum ApoA1 in pulmonary embolism.Results The serum ApoA1 of patients with pulmonary embolism group was significantly lower than that of control group(P<0.05).The level of ApoA1 in patients with PESI gradeⅤwas significantly lower than that in patients with PESI gradeⅠ(P<0.05).The level of serum ApoA1 in high-risk group was significantly lower than that in low-risk group(P<0.05).Serum ApoA1 was negatively correlated with PESI score(r=-0.104,P=0.049).ROC curve results showed that the area under the curve of serum ApoA1 for diagnosing pulmonary embolism was 0.932,the sensitivity was 83.03%,and the specificity was 88.48%.Conclusion Serum ApoA1 was significantly decreased in patients with pulmonary embolism,which was closely related to the severity of pulmonary embolism.Serum ApoA1 can be used as a biomarker for diagnosis and prognosis of pulmonary embolism.