【摘要】 目的 探讨简化肺栓塞严重程度指数（sPESI）联合红细胞分布宽度（RDW）、中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）对非高危急性肺栓塞（APE）患者早期风险的预测价值。方法 收集2018年10月至2022年10月银川市第一人民医院收治的非高危APE患者，根据发病30 d内是否发生复合终点事件分为事件组和非事件组，分析两组患者sPESI评分及各临床指标的差异，寻找非高危APE患者发病30 d内发生复合终点事件的独立预测因子，绘制受试者工作特征（ROC）曲线，评价sPESI联合血常规指标对非高危APE患者早期风险的预测价值。结果 共纳入非高危APE患者187例，其中事件组49例、非事件组138例。两组间sPESI评分、RDW、NLR、MLR、血小板与淋巴细胞比值（PLR）、指脉氧饱和度（SpO₂）、动脉血氧饱和度（SaO₂）、白细胞（WBC）、C反应蛋白（CRP）、肌酐、N-端脑利钠肽前体（NT-proBNP）、乳酸脱氢酶（LDH）、胆碱酯酶、三酰甘油、Na+差异均有统计学意义（P均<0.05）。二元Logistic回归分析结果显示，RDW、NLR、MLR是非高危APE患者发病30 d内发生复合终点事件的独立预测因子（P均<0.05）。绘制ROC曲线发现，sPESI曲线下面积（AUC）为0.761（95%CI:0.683～0.839）,sPESI+RDW+NLR+MLR联合AUC为0.861（95%CI:0.774～0.909）。结论 sPESI联合RDW、NLR、MLR对非高危APE患者早期风险有较高的预测价值，可在基层医疗卫生机构推广应用。更多还原

【Abstract】 Objective To explore the predictive value of the simplified pulmonary embolism severity index(s PESI)in conjunction with red blood cell distribution width(RDW),neutrophil to lymphocyte ratio(NLR)and monocyte to lymphocyte ratio(MLR) for the early risk assessment of patients with non-high risk acute pulmonary embolism(APE). Methods Non-high risk APE patients admitted to the Yinchuan First People’s Hospital from October 2018 to October 2022 were collected. Patients were divided into event and non-event groups based on the occurrence of composite endpoint events within 30 days of onset. The study analyzed the differences in s PESI scores and various clinical indicators between the two groups to identify independent predictors for the occurrence of composite endpoint events in non-high risk APE patients within 30 days.Receiver operating characteristic(ROC)curves were drawn to evaluate the predictive value of combining s PESI with routine blood markers for early risk in non-high risk APE patients. Results This study included 187non-high risk APE patients,with 49 in the event group and 138 in the non-event group. There were statistically significant differences between the two groups in terms of s PESI scores,RDW,NLR,MLR,platelet to lymphocyteratio(PLR),oxygen saturation of the finger pulse(Sp O2),arterial oxygen saturation(Sa O2),C-reactive protein(CRP),creatinine,N-terminal pro-brain natriuretic peptide(NT-pro BNP),lactic dehydrogenase(LDH),cholinesterase,triglycerides,and Na+(P all<0.05). Binary Logistic regression analysis showed that RDW,NLR,and MLR were independent predictors of composite endpoint events within 30 days in patients with non-high risk APE(P all<0.05). ROC curve analysis revealed that the area under the curve(AUC)for s PESI was 0.761(95%CI:0.683-0.839),while the AUC for the combination of s PESI+RDW+NLR+MLR was 0.861(95%CI:0.774-0.909). Conclusion The combination of s PESI,RDW,NLR and MLR has a high predictive value for early risk in patients with non-high risk APE,especially suitable for implementation in primary healthcare institutions.更多还原