Objective:To investigate the prognostic value of pulmonary vascular permeability index(PVPI)combined with carbohydrate antigen 125(CA125)and interleukin-6(IL-6)in patients with acute pulmonary edema.Methods:A total of 86 patients with acute pulmonary edema admitted to our hospital from Feb 2022 to May 2023 were selected.After admission,all patients were treated with mechanical ventilation.According to their 28-day survival,they were divided into the survival group(n=63)and the death group(n=23).PVPI,CA125,IL-6,acute physiology and chronic health status score system Ⅱ(APACHEⅡ),infection-related organ failure score system(SOFA)and oxygenation index(PaO2/FiO2)were compared between the two groups,and the correlation between the level of each index and the prognosis and its effect on prognosis were analyzed.Results:Three days after admission,the scores of PVPI,CA125,IL-6,APACHEⅡ and SOFA in the death group were significantly higher than those in the survival group,and the PaO2/FiO2 was lower than that in the survival group(P＜0.05).PVPI,CA125 and IL-6 were negatively correlated with PaO2/FiO2,but positively correlated with APACHEⅡ and SOFA scores(P＜0.01).The AUC of PVPI,CA125,and IL-6 alone in predicting poor prognosis of acute pulmonary edema was 0.728,0.712,and 0.761,respectively,and the cut-off value was 3.20,58.87 U/ml,28.84 pg/ml.The AUC of combined prediction was 0.834,and the sensitivity was 86.96%,the specificity was 87.30%,which was significantly higher than that of each index alone(P＜0.05).The risk of poor prognosis in patients with high PVPI,CA125,and IL-6 was 3.701,2.945 and 4.217 times that of patients with low PVPI,CA125,and IL-6,respectively(P＜0.05).Conclusions:PVPI,CA125 and IL-6 are significantly correlated with the prognosis of patients with acute pulmonary edema.Combined detection can be used as an important auxiliary way to predict poor prognosis of patients with acute pulmonary edema.