临床误诊误治2024，Vol.37Issue(13)：51-56,6.DOI:10.3969/j.issn.1002-3429.2024.13.011
TAT、TM、PIC、t-PAIC与重型血液毒毒蛇咬伤中毒患者DIC的相关性及预测价值
Correlation of TAT,TM,PIC,and t-PAIC with DIC in Patients with Se-vere Hematotoxic Venomous Snake Bite Poisoning and Their Predictive Value
摘要
Abstract
Objective To evaluate the clinical correlation of thrombin anticoagulase complex(TAT),thrombomodu-lin(TM),plasmin antiplasmin complex(PIC)and tissue plasminogen activation inhibition complex(t-PAIC)with dissemi-nated intravascular coagulation(DIC)after severe hematotoxic venomous snake bite poisoning and their predictive value.Methods A total of 132 patients with severe hematotoxic venomous snake bite poisoning admitted from April 2019 to April 2023 were included as the research subjects.According to presence of DIC during hospitalization,the patients were divided into observation group(occurrence of DIC,n=37)and control group(occurrence of DIC,n=95).Plasma concentrations of TAT,TM,PIC and t-PAIC in the two groups were detected.The clinical correlation between the concentrations of TAT,TM,PIC and t-PAIC and DIC after severe hematotoxic venomous snake bite poisoning was analyzed by binary,noncategorical,un-conditioned Logistic regression analysis.Receiver operating characteristic(ROC)curve was established to analyze the predic-tive ability of TAT,TM,PIC and t-PAIC for DIC after severe hematotoxic venomous snake bite poisoning.Results TAT,TM,PIC and t-PAIC in observation group were significantly higher than those in control group(P＜0.05).Binary,uncondi-tioned Logistic regression analysis without classified covariates showed that TAT[OR=1.517(95%CI:1.155,1.879)],TM[OR=1.647(95%CI:1.108,2.186)],PIC[OR=3.989(95%CI:2.986,4.992)]and t-PAIC[OR=1.111(95%CI:0.854,1.368)]were risk factors for DIC in patients with severe hematotoxic venomous snake bite poisoning(P＜0.05).ROC curve analysis showed that TAT,TM,PIC and t-PAIC were effective indicators for predicting DIC in patients with severe hematotoxic venomous snake bite poisoning(P＜0.05),and the area under the curve(AUC)of the above indica-tors was 0.865(95%CI:0.790,0.939),0.771(95%CI:0.673,0.870),0.847(95%CI:0.804,0.889),and 0.680(95%CI:0.573,0.787),respectively,and the combined prediction efficiency was better(P＜0.001),with the AUC of 0.904(95%CI:0.875,0.933).Conclusion TAT,TM,PIC and t-PAIC detection have important reference value in jud-ging whether DIC occur in patients with severe hematotoxic venomous snake bite poisoning,and can better evaluate the status of patients'coagulation function,and the combined detection of the four indicators is more effective in predicting DIC.关键词
蛇咬伤/血液毒素/中毒/凝血酶抗凝酶复合物/血栓调节蛋白/纤溶酶-抗纤溶酶复合物/组织型纤溶酶原激活抑制复合物/弥散性血管内凝血Key words
Snake bites/Hematotoxin/Poisoning/Thrombin-antithrombin complex/Thrombomodulin/Plasmin anti-plasmin complex/Tissue plasminogen activator inhibitor complex/Disseminated intravascular coagulation分类
医药卫生引用本文复制引用
覃双全,曾宪华,刘笋,何熔,罗亚玲,朱首珍,骆立晖,印伟..TAT、TM、PIC、t-PAIC与重型血液毒毒蛇咬伤中毒患者DIC的相关性及预测价值[J].临床误诊误治,2024,37(13):51-56,6.基金项目
常德市技术创新引导项目(常科函[2022]51号) （常科函[2022]51号）
