Prognostic value of serum level of haptoglobin for acute pulmonary embolism

Objective To investigate the changes of serum level of haptoglobin （HP） in patients with acute pulmonary embo1ism （APE） and evaluate the clinical value in evaluating the clinical prognosis of APE patients. Methods Sixty-five APE patients （APE group） and 50 healthy controls （control group） during physical examination were recruited in this study. The serum levels of HP and D-dimer （DD） were detected in two groups. The severity of APE was assessed by using pulmonary embolism severity index （PESI）. Patients were followed up for 6 months after treatment and divided into the survival and death groups. The serum levels of HP and DD and PESI score upon admission were statistically compared between two groups. The correlation between the serum level of HP and DD/PESI score was statistically assessed. The values of HP and DD in evaluating APE were analyzed by using the receiver operating curve （ROC）. Results The serum levels of HP and DD in the APE group were significantly higher than those in the control group （both P < 0.05）. Among 65 APE patients, the serum levels of HP and DD and PESI score in the high-risk group were remarkably higher than those in the middle- and low-risk groups （all P <0.05）. The serum levels of HP and DD and PESI score in the middle-risk group were significantly higher compared with those in the low-risk group （all P < 0.01）. During 6-month follow-up, 57 patients survived and 8 died. The serum levels of HP and DD and PESI score upon admission in the death group were considerably higher than those in the survival groups （all P < 0.001）. In the APE patients, the serum level of HP was positively correlated with DD （r = 0.617,P < 0.001） and PESI score （r = 0.740, P < 0.001）. The area under ROC curve （AUC） of HP in predicting poor prognosis of APE patients was significantly larger than that of DD （P < 0.05）. Conclusions The serum level of HP is evidently up-regulated in APE patients, which is gradually increased along with the disease aggravation. HP is an effective parameter to predict the clinical prognosis of APE patients.