中国中西医结合急救杂志2025，Vol.32Issue(1)：21-24,4.DOI:10.3969/j.issn.1008-9691.2025.01.004
TAT、sTM和t-PAIC对脓毒症患者凝血功能紊乱的评估价值
The value of thrombine-antithrombin complex,soluble thrombomodulin and tissue-plasminogen activator-inhibitor complex in the evaluation of coagulation dysfunction in patients with sepsis
摘要
Abstract
Objective To evaluate the value of molecular markers of thrombine-antithrombin complex(TAT),soluble thrombomodulin(sTM),tissue-plasminogen activator-inhibitor complex(t-PAIC)in the early diagnosis of disseminated intravascular coagulation(DIC)in sepsis patients.Methods Thirty patients diagnosed with DIC secondary to hemoinfect-induced sepsis were selected as the DIC group in the intensive care unit(ICU)of the First Hospital of Lanzhou University from July to September 2023.Thirty patients with sepsis caused by bloodstream infection without DIC were randomly selected as the sepsis group.General data and procalcitonin(PCT),platelet count(PLT),white blood cell count(WBC),the levels of traditional clotting indexes activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(Fib),D-dimer and new clotting indexes(TM,TAT,t-PAIC)were collected.The indicators with statistical significance in univariate analysis were included in multivariate Logistic regression analysis to screen the independent risk factors for DIC in sepsis patients.Receiver operator characteristic curve(ROC curve)was drawn to analyze the diagnostic value of TM,TAT,t-PAIC and their combination in the occurrence of DIC in sepsis patients.Results A total of 60 patients with sepsis were included.There was no significant difference in gender,age,PCT,PLT and WBC between the DIC group and the sepsis group.In terms of traditional coagulation indexes,the PT level in sepsis DIC group was significantly lower than that in sepsis group,and the Fib level was significantly higher than that in sepsis group(both P<0.05).There were no statistically significant differences in APTT and D-dimer levels between the two groups.In terms of new coagulation indexes,TAT,sTM and t-PAIC levels in sepsis DIC group were significantly higher than those in sepsis group(all P<0.05).Multivariate Logistic regression analysis showed that TAT,sTM were independent risk factors for DIC in sepsis patients(both P<0.05).ROC curve analysis showed that TAT,sTM,t-PAIC combined detection had certain value in diagnosis of DIC in sepsis patients,area under the curve(AUC)was 0.735;when the cut-off value was 0.73,the sensitivity was 100.0%and specificity was 43.3%.Conclusion TAT,sTM and t-PAIC could help to predict DIC in sepsis.关键词
脓毒症/凝血功能紊乱/凝血酶-抗凝血酶复合物/组织纤溶酶原激活物-溶酶原激活物抑制剂复合物/可溶性血栓调节蛋白Key words
Sepsis/Coagulation disorder/Thrombine-antithrombin complex/Tissue-plasminogen activator-inhibitor complex/Soluble thrombomodulin引用本文复制引用
许小英,岳熊,冉晓丽,德吉康卓,阿卜杜合力力·麦合木提,阿丽米热·艾尼江,其米宗巴..TAT、sTM和t-PAIC对脓毒症患者凝血功能紊乱的评估价值[J].中国中西医结合急救杂志,2025,32(1):21-24,4.基金项目
国家自然科学基金(82360800) （82360800）
甘肃省卫生健康行业科研项目(GSWSQN2024-05)National Natural Science Foundation of China(82360800) （GSWSQN2024-05）
Gansu Provincial Health Industry Scientific Research Project(GSWSQN2024-05) （GSWSQN2024-05）
