摘要
Abstract
Objective To analyze the value of plasmin-α2-plasmin inhibitor complex(PIC)and thrombin-antithrombin complex(TAT)for risk stratification of massive transfusion(MT)in patients with postpartum hemorrhage(PPH).Methods Clinical data and blood samples of patients with PPH in our hospital from January 2019 to December 2022 were retrospectively analyzed.MT(MT group,n=60)was defined as transfusion of red blood cells≥10 U within 24 h after delivery,and＜10 U was defined as non-MT group(n= 190).Plasma PIC and TAT levels were detected by chemiluminescence immunoassay at the onset of PPH.Results Compared with non-MT group,PPH pa-tients in MT group had higher TAT[2.20(1.20,3.00)ng/mL vs 4.00(2.20,6.30)ng/mL,Z=-5.464,P＜0.001]and PIC[0.99(0.82,1.13)μg/mL vs 1.11(1.05,1.55)μg/mL,Z=-7.228,P＜0.001]level.The analysis of receiver operator characteristic curve showed that the area under the curve required for MT after TAT and PIC combined to predict PPH was 0.820(95%CI:0.756-0.886),and the positive likelihood ratio was 4.76 and the negative likelihood ratio was 0.35,which was significantly better than the two predictions alone.Multivariate logistics regression analysis showed that TAT level＞3.25 ng/mL and PIC level＞1.04 μg/mL were independent risk factors for MT after PPH.Conclusion Elevated TAT and PIC levels are independent predictors of MT in patients with PPH,and their combined predictive efficacy is better.关键词
纤溶酶-α2-纤溶酶抑制剂复合物/凝血酶-抗凝血酶复合物/产后出血/大量输血Key words
plasmin-α2-plasmin inhibitor complex(PIC)/thrombin-antithrombin complex(TAT)/postpartum hemor-rhage/massive transfusion分类
临床医学
