心肌脂肪酸结合蛋白联合简化肺栓塞严重指数对急性肺栓塞短期预后的评估

［摘要］目的　探讨心肌脂肪酸结合蛋白（H-FABP）联合简化肺栓塞严重指数（sPESI）评估血液动力学稳定的急性肺栓塞（APE）短期预后的临床价值．方法　纳入130例血液动力学稳定APE患者，测定H-FABP和进行sPESI评分．结果　13例（10.0%）患者出现30 d不良事件．H-FABP［OR， 4.96（1.70-14.42），P＝0.003］与sPESI ［OR，9.50（2.24-40.28），P＝0.002］是血液动力学稳定的APE短期预后的预测因子．30例H-FABP＜6 μg/L且sPESI 0分组的患者，无1例出现30 d不良转归．H-FABP≥6 μg/L联合sPESI≥1分对血液动力学稳定APE患者的30 d预后的预测敏感度和阴性预测值均为100%．结论　H-FABP和sPESI能有效预测血液动力学稳定的APE患者短期预后，H-FABP联合sPESI能提高短期预后的预测敏感性，尤其有助于识别低危APE患者．

Combination of Heart-type Fatty Acid-binding Protein and Simple Pulmonary Embolism Severity Index for the Assessment of the Short-term Prognosis in Patients with Acute Pulmonary Embolism

［Abstract］Objective To evaluate the short-time prognostic value of combination of Heart-type fatty acid-binding protein (H-FABP) and simple Pulmonary Embolism Severity Index (sPESI) in normotensive patients with acute pulmonary embolism (APE). Methods　One hundred and thirty normotensive patients with APE were enrolled. The plasma concentration of H-FABP was analyzed and the sPESI scores were calculated．Result　13(10%) patients had adverse 30-day outcome. The H-FABP［OR, 4.96（1.70-14.42），P = 0.003］and sPESI ［OR, 9.50（2.24-40.28），P = 0.002］were predictors for short-term prognosis of normotensive APE. All of the 30 patients (23.1%) with sPESI score 0 and H-FABP＜6 μg/L had no adverse 30-day outcome. The combination model of H-FABP ≥6 μg/L with sPESI≥1 point(s) was associated with increased prognostic sensitivity and negative predictive value, which both reached 100%．Conclusions　The H-FABP assay and the sPESI are useful prognostic indicators for 30-day outcome of normotensive APE. The combination of the both predictors can yield additive prognostic information and particularly identify low-risk patients with APE.