Correlation Research Of Inflammation Biomarker In The Pulmonary Embolism

Objective:Through detecing the level of blood neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),red cell distribution width(RDW)and interleukin-6(IL-6),hypersensitive creactive protein(hs-CRP),hypersensitive troponin T(hs-TnT),D-dimer(DD)in plasma of patients with pulmonary embolism(PE),explore their value in the diagnosis and severity evalution for PE.Methods:1 Collected 70 cases of PE patients who met inclusive and exclusive standards from January 2016 to December 2017-treated in the Second Affiliated Hospital of Kunming Medical University respiratory department as the observation group,30 healthy controls of our department in the same period as the control group.Collected indexes that inclued gender,age,CT pulmonary angiography(CTPA),neutrophil(N),lymphocyte(L),platelet(PLT),RDW,IL-6,hs-CRP,DD,hs-TnT andassociated diseases.2 According to the result of CTPA and whether or not main pulmonary artery embolism,the 70 cases of PE patients were divided into non-main pulmonary artery embolism PE group 40 cases and malin pulmonary artery embolism PE group 30 cases.The gender,age and NLR,PLR,RDW,IL-6,DD,hs-CRP,hs-TnT of the control group was compared with the above two groups.3 Drawed the receiver operating characteristic curve(ROC curve)of NLR,PLR,RDW,IL-6,DD,hs-CRP and about the observation group and the control group,to analysis the value of NLR,PLR,DD,RDW,IL-6,hs-CRP in the diagnosis of PE by the ROC curve.The Spearman rank correlation coefficient was used to value the correlation of NLR,PLR,RDW,IL-6,hs-CRP and DD,hs-TnT.Results:1 There were no significant difference in gender,age among the patients of control group,non-main pulmonary artery embolism PE group and main pulmonary artery embolism PE group(P>0.05).The comparison of the two groups showed that the patients with non-main pulmonary artery embolism PE group were higher than those in the control group NLR,PLR,RDW,IL-6,hs-CRP,DD and hs-TnT,the results were statistically significant(P<0.017).The patients of main pulmonary artery embolism PE group compared with non-main pulmonary artery embolism PE group,the level of NLR,RDW,IL-6,hs-CRP,DD,hs-TnT were higher than those in non-main pulmonary artery embolism PE group,the results had more significant difference(P<0.017).But PLR was no significance in the two groups(P>0.017).The patient of main pulmonary artery embolism PE group compared with the control group,the level of NLR,PLR,RDW,IL-6,hs-CRP,DD,hs-TnT were higher than those in the control,and the results had obvious statistical significance(P<0.017).2 Taking the observation group and control group as the study object,the ROC curve showed that AUCs of NLR,PLR,RDW,IL-6,hs-CRP and DD to diagnose the PE were 0.941±0.022,0.858±0.036,0.789±0.050,0.836±0.041,0.856±0.038,0.983±0.009,the results showed NLR,PLR,RDW,IL-6,hs-CRP,DD were consistent in the diagnosis of PE.NLR and DD in the diagnosis of PE have a higher value,the results were highly significant(P<0.001),the best cut-off values were 2.741,0.505ug/mL,the sensitivities were 87.1%,92.9%,their specificities were 93.3%,96.7%,The results showed that PLR,RDW,IL-6,hs-CRP have a certain value in diagnosis of PE.The optimal cut-off were 134.92,14.05%,8.74pg/mL,10.21mg/L,their sensitivities were 81.4%,68.6%,78.6%,78.6%,their specificities were 80%,80%,90%,90%,the results had more significant difference(P<0.001).3 Taking the control group and the observation group as the study object,the NLR,PLR,RDW,IL-6,hs-CRP,DD were examined by the normal test.The result showed these indexes were not in the normal distribution.The correlation coefficient between these indexes were analyzed by Spearman correlation.Corrlation analysis showed that NLR,PLR,RDW,IL-6,hs-CRP,DD were positively correlated.There was a highly strong corrlation between NLR and DD,there were moderate correlation between PLR,RDW,IL-6,hs-CRP and DD,the results were statistically signifaicant(P<0.001).Corrlation analysis showed that NLR,PLR,RDW,IL-6,hs-CRP and hs-TnT were positively correlated.The correlation between NLR,PLR,RDW,IL-6,hs-CRP and hs-TnT were moderate correlated,the result was statistically signifaicant(P<0.001).Conclusion:1 The level of inflammatory indexs NLR,PLR,RDW,IL-6,hs-CRP,hs-TnT were positively correlated in PE,and the level of NLR,RDW,IL-6,hs-CRP,DD,hs-TnT in PE patients were increased with PE severity.The above indexes may be significantly associated with the progression of the disease.But the PLR was not related to the severity of PE.NLR,RDW,IL-6,hs-CRP may can provide an important basis for the assessment of the severity of PE.2 The level of NLR,PLR,RDW,IL-6,hs-CRP,DD were increased in PE patients.The NLR and DD with highly diagnostic value,good sensitivity and pecificity,could be applied for the diagnosis of PE patients.However,the sensitivity or pecificity of PLR,RDW,IL-6 and hs-CRP in the diagnosis of PE were lowed,compared the above indexs,the clinical significance is not great.3 The level of NLR and DD was highly strong corrlation in PE patient,there were moderate correlation between PLR,RDW,IL-6,hs-CRP and DD.So the level of NLR,PLR,RDW,IL-6 and hs-CRP may indirectly reflect the thrombotic state of PE patients.4 The limitation of this study is the small sample size,no observation of dynamic changes of NLR,PLR,RDW,IL-6,hs-CRP.In order to obtain a comprehensive and objective conclusion,we will further expand the sample size in later period.