Objective      To investigate the value of plasma heart-type fatty acid-binding protein (H-FABP) level and Acute Physiology and Chronic Health Evaluation (APACHEⅡ) score system in the estimation of severity and prognosis for the patients with acute pulmonary embolism (APE).       Methods      Clinical data of 160 APE patients (92 males and 68 females

at a mean age of 51±12) admitted in our hospital from January 2010 to January 2015 were collected and retrospectively analyzed. According to the severity

these patients were divided into low-risk group (n=58

33 males and 25 females

at a mean age of 50±13)

moderate-risk group (n=54

30 males and 24 females

at a mean age of 54±12)

and high-risk group (n=48

29 males and 19 females

at a mean age of 52±10). Based on their clinical outcomes

the patients were also assigned into survival (n=132) and death (n=28) groups. Their plasma level of H-FABP was measured by enzyme linked immunosorbent assay (ELISA)

and APACHEⅡ score was evaluated. The differences of plasma H-FABP level and APACHEⅡ score were compared among the groups

and the value of the 2 indexes in the evaluation of the severity and prognosis of APE were also assessed.       Results       With the increased severity in the patients

the H-FABP level and APACHEⅡ score were significantly increased (P0.05). The level and the score were significantly higher in the death group than the survival group (P0.05). Correlation analysis showed that the H-FABP level was positively correlated to APACHEⅡ score (r=0.71

P=0.000). Receiver operator characteristic (ROC) curve analysis indicated that the area under curve (AUV) of H-FABP was 0.854 (95%CI: 0.784~0.927). When the level was higher than 13.3 μg/L

the sensitivity and specificity were 81.0% and 79.4% respectively. The ACU of APACHEⅡ was 0.861 (95%CI: 0.825~0.948)

and when APACHEⅡ score was larger than 19.2

with the sensitivity of 77.8%

and the specificity of 80.4%. When the 2 cutoff values were combined together

the AUC was 0.914 (95%CI: 0.812~0.932)

and the sensitivity was 88.9% while specificity 87.6%

both obviously higher than H-FABP and APACHEⅡ score alone.       Conclusions       The sensitivity and specificity of combined H-FABP with APACHEⅡ score are superior to H-FABP and APACHEⅡ score alone in assessment of severity and prognosis of APE patients. And the combination provides an objective basis for clinical individual treatment and reducing the mortality in the patients.