| Objective: To investigate the changes of WBC,neutrophils,lymphocytes,NLR,PLR and serum IL-6 levels in PE patients pre-and post-treatment,the correlations between pulmonary artery obstruction index(PAOI)and the inflammation biomarkers above.And explore the clinical significance of the inflammation biomarkers' changes in assessing the thrombus load and the resent thrombus resolvation.Methods: Forty-seven PE patients first-diagnosed by CTPA were studied prospectively which named as PE group in 3 hospitals from June2015 to February 2017,and thirty-seven healthy subjects were compared as the control group during the same period.The differences of WBC,neutrophils,lymphocytes,NLR,PLR and serum IL-6 levels were compared between the PE group with the control group,also the differences of them pre-and post-treatment in PE group.The PAOI of PE group was evaluated according to Mastora scores.PE patients were divided into low-obstruction group(PAOI < 30%),medium-obstruction group(PAOI 30%~50%),high-obstruction group(PAOI>50%)based onthe different PAOI and the inflammation biomarkers were compared among groups.Dynamic changes of inflammation biomarkers within14-day-treatment were monitored in PE group,also the relationships of these biomarkers with PAOI and PAOI varies were analyzed.Results: Compared with the control group,the WBC,neutrophils,NLR,PLR and IL-6 were significantly higher in PE group((10.44 ±3.18)×109/L vs(6.37 ± 2.19)×109/L P=0.000,(7.95 ± 3.03)×109/L vs(3.74 ± 2.41)×109/L P=0.000,5.43 ± 3.92 vs 1.71 ± 0.74 P=0.000,165.58 ± 136.73 vs 123.18 ± 51.05 P=0.01,25.14 ± 25.97 vs 6.45 ± 7.15P=0.000,respectively),the lymphocytes significantly lowered in the PE group((1.55 ± 0.64)×109/L vs(2.20 ± 0.57)×109/L P=0.000).With the increase of PAOI,the WBC,neutrophils,NLR,and IL-6 levels were increasing from low to medium and high obstruction group(P values were 0.038,0.024,0.049,0.000,respectively).The WBC,neutrophils and NLR had been declining within 14-treatment;the lymphocytes rose from the 1st to 3rd day after treatment,kept stable from the 3rd to 7th day and then rose again from the 7th to 14 th day;PLR declined from the 1st to3 rd day after treatment,rose from the 3rd to 7th day and kept stable from the 7th to 14 th day.The WBC,neutrophils,NLR and IL-6 in PE group were significantly lower on the 14 th day than those before treatment((10.44 ± 3.18)×109/L vs(6.93 ± 2.46)×109/L P=0.000,(7.95 ±3.03)×109/L vs(4.31 ± 2.08)×109/L P=0.000,5.43 ± 3.92 vs 2.55 ± 1.50P=0.000,25.14 ± 25.97 vs 6.25 ± 7.45 P=0.000,respectively),and the lymphocytes increased significantly((1.55 ± 0.64)×109/L vs(1.90 ±0.37)×109/L,P = 0.000),but there was no significant difference on PLR pre-and post-treatment(P=0.421).It showed a moderately positivecorrelation between WBC,neutrophils,NLR,IL-6 and PAOI before treatment(r values were 0.394,0.430,0.417,0.547;P values were 0.006,0.003,0.004,0.000,respectively),also a moderately negative correlation between NLR with the varied rate of PAOI pre-and post-treatment(R=-0.352 P=0.015),but a moderately positive correlation between lymphocytes with the varied rate of PAOI pre-and post-treatment(r=0.335,P=0.021)in contrast.It also showed a moderately positive correlation between IL-6 and PAOI after treatment(r=0.498,P=0.000).Conclusions: The WBC,neutrophils,NLR and IL-6 levels in PE patients before treatment could reflect thrombus load.The lower level of NLR and the higher level of lymphocytes before treatment,the more significant of the thrombolytic effect.The WBC,neutrophils,NLR and IL-6 decline continuously and the lymphocytes rise in contrast,indicating that the inflammation is weakened and the thrombus is dissolving and absorbed,which could reflect the thrombus resolvation recently.The IL-6is positively correlated with PAOI after treatment,which could reflect the degree of residual thrombus load in PE patients. |
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