Clinical research on heart-type fatty acid-binding protein and APACHE Ⅱ in severity and prognosis estimation for patients with acute pulmonary embolism / 中华胸心血管外科杂志

ABSTRACT

Objective To investigate the value of plasma H-FABP level and Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ) in severity and prognosis estimation for patients with acute pumonary embolism(APE).Methods Totally 160 APE patients were hospitalized from January 2010 to January 2015 and enrolled in this study.According to the severity of the disease,these patients with APE were divided into low-risk group,moderate-risk group and high-risk group.According to clinical prognosis,these patients with APE were divided into survival groups and death groups.Plasma levels of H-FABP were measured by enzyme linked immunosorbent assay(ELISA),and APACHE Ⅱ score were analyzed.The differences of Plasma H-FABP levels and APACHE Ⅱ score were compared and which the relationship with severity and the prognosis of APE were also assessed.Results With the increased severity in patients,the H-FABP and APACHE Ⅱ score were significantly increased (P ＜ 0.05);the H-FABP and APACHE Ⅱ score were significantly higher in death group as compared with survival group(P ＜0.05).The H-FABP levels and APACHE Ⅱ score were positive correlated(r =0.71,P =0.000).ROC curves analysis results showed that the area under curve of H-FABP was 0.854 (95 ％ CI0.784-0.927),and optimal operating point (OOP)was 13.3 μg/L,which had 81.0％ sensiticity and 79.4％ specificity;ACU of APACHE Ⅱ was 0.861 (95％ CI0.812-0.932),and OOP was 19.2,which had 77.8％ sensiticity and 80.4％ specificity.The AUC was 0.914 (95％ CI0.825-0.948),and the sensitivity was 88.9％,specificity was 87.6％ when the two cutoff values were both achieved,which were higher than the single H-FABP and APACHE Ⅱ score.Conclusion The H-FABP and APACHE Ⅱ score can effectively assess severity and prognosis of APE patients,meanwhile,it provide an objective basis for the clinical individual treatment and reducing the mortality rate of APE patients.