Abstract: Objective To analyze the expression of fractalkine (FKN), heart-type fatty acid-binding protein (H-FABP) and D-dimer (D-D) in acute pulmonary embolism and their clinical significance. Methods A total of 43 patients with acute pulmonary embolism admitted to Zhoukou First People's Hospital from October 2020 to October 2021 were selected as the study group, and 50 healthy people who underwent physical examination during the same period were selected as the control group. The levels of serum FKN, H-FABP and D-D in the two groups were measured by double antibody sandwich ELISA and immunoturbidimetry respectively, and their expression and clinical significance were analyzed. Results Compared with low-risk and medium-risk patients in control group and study group, the levels of FKN, H-FABP and D-D in high-risk patients were higher (P<0.05), FKN, H-FABP and D-D were positively correlated with the risk grade of acute pulmonary embolism. FKN and H-FABP were positively correlated in patients with acute pulmonary embolism (r=0.503, P=0.010). There was positive correlation between FKN and D-D (r=0.682, P=0.001). There was positive correlation between H-FABP and D-D (r=0.755, P=0.001). ROC curve analysis showed that FKN, H-FABP and D-D (AUC =0.651,0.692,0.740) combined (AUC =0.844) had higher diagnostic value for acute pulmonary embolism (P<0.05). Conclusion The occurrence and pathological progress of acute pulmonary embolism may be related to the abnormal expression of serum FKN, H-FABP and D-D, and the combination of the three has important significance for the early diagnosis of acute pulmonary embolism.

Key words: acute pulmonary embolism, fractalkine, heart-type fatty acid-binding protein, D-dimer

摘要： 目的 分析不规则趋化因子(FKN)、心肌型脂肪酸结合蛋白(H-FABP)、D二聚体（D-D）在急性肺栓塞中的表达及对临床意义。方法 选取2020年10月~2021年10月周口市第一人民医院收治的43例急性肺栓塞患者为研究组,选取50例同期体检健康人员为对照组,分别采用双抗体夹心ELISA法、免疫比浊法测定2组患者血清FKN、H-FABP、D-D水平,对其表达及临床意义进行分析。结果 相比对照组、研究组低危、中危患者,高危患者FKN、H-FABP、D-D水平较高（P<0.05）,FKN、H-FABP、D-D与急性肺栓塞危险分级呈正相关;急性肺栓塞患者FKN、H-FABP呈正相关（r=0.503,P=0.010）;FKN、D-D呈正相关（r=0.682,P=0.001）;H-FABP、D-D呈正相关（r=0.755,P=0.001）。ROC曲线分析结果显示FKN、H-FABP、D-D（AUC值=0.651,0.692,0.740）三项联合（AUC值=0.844）对急性肺栓塞的诊断价值较高（P<0.05）。结论 急性肺栓塞的发生及病理进展或与血清FKN、H-FABP、D-D呈异常表达相关,三项联合对急性肺栓塞早期诊断具有重要意义。

关键词: 急性肺栓塞, 不规则趋化因子, 心肌型脂肪酸结合蛋白, D二聚体