Clinical Value of Plasma ADAMTS-13 Activity and NLR in Diagnosis of Acute Pulmonary Thromboembolism
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0605
- VernacularTitle:血浆ADAMTS-13活性和NLR在急性肺血栓栓塞症中的诊断价值
- Author:
Zi-xuan HU
1
;
Wan-mei HE
1
;
Mian ZENG
1
Author Information
1. Medical Intensive Care Unit， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
- Publication Type:Journal Article
- Keywords:
acute pulmonary thromboembolism;
inflammation;
vWF activity;
ADAMTS-13 activity;
NLR
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(6):831-838
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThe purpose of this study was to compare the expression of plasma vWF activity， ADAMTS-13 activity and neutrophil-to-lymphocyte ratio （NLR） between patients with acute pulmonary thromboembolism （PTE） and healthy controls， and to explore the clinical value of plasma ADAMTS-13 activity and NLR in diagnosis of acute PTE. MethodsTotally 64 patients with acute PTE and 30 healthy controls were included. Collected clinical data and detected the plasma vWF activity and ADAMTS-13 activity by enzyme linked immunosorbent assay （Elisa）. The correlation between ADAMTS-13 activity and other clinical indexes was explored. Receiver operating characteristic curve （ROC） was mapped to evaluate the activity of ADAMTS-13 and NLR in the diagnosis of patients with acute PTE. ResultsThe comparison between the healthy control group and the acute pulmonary thromboembolism group showed that the ADAMTS-13 activity levels were 83.8% （72.2%， 98.8%） and 63.3% （49.6%， 74.8%）， respectively， the VWF activity levels were 102.7% （89.7%， 117.2%） and 122.6% （96.8%， 156.6%）， respectively， and the differences between the two groups were statistically significant （P＜0.05）. Spearman correlation analysis showed that there was a negative linear correlation between ADAMTS-13 activity and vWF activity with D-dimer （P＜0.05）. The results of multivariate Logistic regression showed that the increase of NLR was an independent risk factor for acute PTE ［OR=1.66， 95% CI （1.10， 2.47）， P=0.014］ and the increase of ADAMTS-13 activity was an independent protective factor for acute PTE ［OR=0.92， 95% CI （0.88， 0.964）， P＜0.001］. When used in the diagnosis of acute PTE， the area under the curve （AUC） for ADAMTS-13 activity was 0.861， 95%CI （0.780， 0.942）， P＜0.001. When combined with NLR， the AUC was 0.902， 95%CI（0.841， 0.963）， P＜0.001. ConclusionsOur results show plasma ADAMTS-13 activity is significantly decreased and vWF activity is significantly increased in patients with acute PTE. ADAMTS-13 and vWF may be the bridge between thrombosis and inflammation. Combined with NLR， plasma ADAMTS-13 activity can improve the accuracy of diagnosis of acute PTE. Our results provide new ideas for exploring the pathogenic mechanism of acute PTE， and provide experimental basis for exploring therapeutic target of acute PTE.
