| Objective:To explore the value of renal biochemical indexes in predicting the short-term prognosis of patients with acute pulmonary embolism(APE).Methods:The clinical data of 228 patients with APE diagnosed for the first time in the First Affiliated Hospital of Shanxi Medical University from January 2014 to December 2021 were retrospectively analyzed.The patients were followed up for 3 months,and the short-term adverse prognosis was counted.The renal function biochemical indexes of the poor prognosis group and the good prognosis group were compared.Multivariate Logistic regression was used to analyze the risk factors affecting poor prognosis of APE patients,and receiver operating characteristic(ROC)curve was used to analyze its predictive efficacy for poor prognosis of APE patients.Result:In this study,a total of 145 APE patients were enrolled in the good prognosis group and 83 in the poor prognosis group,with the incidence of poor prognosis being 36.40%(83/228).In the good prognosis group,48.3%(70 cases)of males and 51.7%(75 cases)of females,with an average age of(65.88±8.131)years;In the poor prognosis group,55.4%(46 cases)of males and 44.6%(37 cases)of females,with an average age of(67.10±10.156)years.There were no significant differences in gender,age,body mass index,pulse,systolic blood pressure and composition of complications between 2 groups(all P > 0.05).Serum BUN,UA and Cys C in poor prognosis group were higher than those in good prognosis group(all P < 0.05),while serum Cr Cl,calcium ion and sodium ion in poor prognosis group were lower than those in good prognosis group(all P < 0.05).Multivariate analysis showed that high BUN(OR= 2.413,95%CI 1.548-3.760,P<0.001)and UA(OR= 1.017,95%CI 1.010-1.025,P<0.001)were risk factors for poor prognosis of acute pulmonary embolism.High levels of Cr Cl(OR= 0.970,95%CI 0.949-0.991,P=0.006)and calcium(OR= 0.059,95%CI 0.005-0.688,P=0.024)were protective factors for poor prognosis of acute pulmonary embolism(P<0.05).ROC curve was drawn,and the results showed that the area under the curve of Cr Cl to predict the risk of poor prognosis in APE patients at 3 months was 0.870,and the optimal cut-off value was74.370 m L/min(sensitivity 77.1%,specificity 84.1%).The area under the curve of BUN was 0.923,and the optimal cut-off value was 5.135mmol/L(sensitivity 90.4%,specificity83.4%).The area under the curve of UA was 0.867,and the optimal cut-off value was325.500 umol/L(sensitivity 78.3%,specificity 81.4%).The area under curve of serum calcium ion was 0.655,and the optimal cut-off value was 2.105mmol/L(sensitivity53.0%,specificity 72.4%).The area under the curve of the four combined tests was 0.970,with a sensitivity of 95.2% and specificity of 91.0%.The diagnostic efficacy of APE patients was significantly superior to each single test(P < 0.05).Conclusion:1.Elevated serum BUN and UA levels are risk factors for poor prognosis in patients with acute pulmonary embolism,and elevated serum Cr Cl and calcium ion levels are protective factors for poor prognosis in patients with acute pulmonary embolism.2.Serum Cr Cl,BUN,UA and calcium ions were closely related to the prognosis of patients with acute pulmonary embolism,and the combination of the four groups had higher predictive efficacy in predicting short term poor prognosis of patients with acute pulmonary embolism. |
PDF Full Text Request