Study On The Risk Stratification Of Patients With Acute Pulmonary Embolism By Plasma D-Dimer,mean Platelet Volume And Pulmonary Artery Pressure

Objective:To investigate the value of plasma D-Dimer,mean platelet volume and pulmonary artery pressure in risk stratification in patients with acute pulmonary embolism.Methods:This study retrospectively selected 96 patients diagnosed with acute pulmonary embolism in Chengde Central Hospital from October 2015 to October 2018.General data,blood pressure level,plasma D-Dimer,mean platelet volume,Cardiac biomarker,and echocardiography of the patients were collected.According to the risk stratification criteria in the latest guidelines on diagnosis,treatment and prevention of pulmonary thromboembolism published by the Chinese medical association in 2018,APE patients were divided into high-risk,middle-risk and low-risk groups.The general data,plasma D-Dimer,mean platelet volume and pulmonary artery pressure of the three groups were compared,and the correlation between plasma D-Dimer,mean platelet volume and pulmonary artery pressure was analyzed.Results:1 Comparison of general data of acute pulmonary embolism patients with different risk stratificationThere was no significant difference in gender,age,underlying disease,smoking,chest pain,hemoptysis and syncope in the high-risk,middle-risk and low-risk groups(P>0.05).The proportion of dyspnea in high-risk group and middle-risk group was higher than that in low-risk group(P<0.05),but there was no statistical significance between high-risk group and middle-risk group(P>0.05).The proportion of pulmonary infarction triad in high-risk group was higher than that in low-risk group(P<0.05),and there was no statistical significance among other groups(P>0.05).2 Comparison of plasma D-Dimer,mean platelet volume and pulmonary artery pressure in patients with acute pulmonary embolism with different risk stratificationThe plasma D-Dimer in the high-risk,middle-risk and low-risk groups was(3425.1±589.2)ng/ml,(2261.3±462.6)ng/ml and(1154.3±338.5)ng/ml,respectively,P<0.05.The mean platelet volume in the high-risk,middle-risk and low-risk groups was(10.8±1.7)fl,(9.5±1.6)fl and(8.4±1.6)fl,respectively,P<0.05.Pulmonary artery pressure in the high-risk,middle-risk and low-risk groups was(43.2±7.2)mm Hg,(27.9±4.8)mm Hg and(23.5±4.8)mm Hg,respectively,P<0.05.3 Correlation between pulmonary artery pressure and plasma D-Dimer in patients with acute pulmonary embolismPulmonary artery pressure was positively correlated with plasma D-Dimer in patients with acute pulmonary embolism,r2=0.777(r=0.881),P<0.001.4 Correlation between pulmonary artery pressure and mean platelet volume in patients with acute pulmonary embolismPulmonary artery pressure was positively correlated with mean platelet volume in patients with acute pulmonary embolism,r2=0.579(r=0.761),P<0.001.5 Correlation between pulmonary artery pressure and plasma D-Dimer in patients with acute pulmonary embolism with different risk stratificationPulmonary artery pressure in high-risk group was positively correlated with plasma D-Dimer,r2=0.615(r=0.784),P=0.015.Pulmonary artery pressure in middle-risk group was positively correlated with plasma D-Dimer,r2=0.509(r=0.713),P<0.001.There was no correlation between pulmonary artery pressure and plasma D-Dimer in the low-risk group,r2=0.341(r=0.584),P=0.060.6 Correlation between pulmonary artery pressure and mean platelet volume in patients with acute pulmonary embolism with different risk stratificationPulmonary artery pressure was positively correlated with mean platelet volume in the high-risk group,r2=0.762(r=0.873),P=0.002.Pulmonary artery pressure was positively correlated with mean platelet volume in the middle-risk group,r2=0.505(r=0.711),P=0.038.There was no correlation between pulmonary artery pressure and mean platelet volume in the low-risk group,r2=0.165(r=0.406),P=0.374.Conclusion:1 Plasma D-Dimer,mean platelet volume and pulmonary artery pressure have good value for risk stratification in patients with acute pulmonary embolism.2 There was a good correlation between plasma D-Dimer,mean platelet volume and pulmonary artery pressure in the middle-risk and high-risk groups.