摘要
目的 探讨纤溶酶—抗纤溶酶复合物(PIC)和组织型纤溶酶原激活抑制复合物(t-PAIC)、凝血酶抗凝酶复合物(TAT)、血栓调节蛋白(TM)与胡蜂蜇伤预后的关系。方法 选取2019年4月至2023年3月湖南省常德市第一人民医院急诊科收治的胡蜂蜇伤患者78例,根据患者预后情况分为预后良好组及预后不良组。比较2组一般资料及PIC、t-PAIC、TAT、TM、D-二聚体(DD)、纤维蛋白降解物(FDP)、凝血酶原时间(PT)、活化凝血酶时间(APTT)。制作受试者工作特征曲线(ROC)分析上述因素对胡蜂蜇伤预后的预测效能。结果 预后不良组血管内溶血比例、APACHEⅡ评分、SOFA评分、蜇伤针数及乳酸水平均高于预后良好组(P<0.05)。预后不良组血浆TAT、TM、PIC和t-PAIC水平高于预后良好组(P<0.05)。预后不良患者FDP、DD、APTT、PT高于预后良好组(P<0.05)。PIC、t-PAIC、TAT、TM均为影响胡蜂蜇伤预后不良的危险因素(P<0.05)。ROC曲线分析结果显示,TAT、TM、PIC、t-PAIC及四者联合对胡蜂蜇伤所致预后不良预测的灵敏度分别为67.90%、75.00%、53.60%、64.30%、89.00%,AUC分别为0.799、0.767、0.690、0.678、0.919。结论 预后不良患者的PIC、t-PAIC、TAT、TM水平异常,四者联合对胡蜂蜇伤所致预后不良的早期预测价值较高。
Objective To explore the correlation between plasminogen activator inhibitor-complex(PIC),tissue-type plasminogen activator inhibitor complex(t-PAIC),thrombin-antithrombin complex(TAT),thrombomodulin(TM),with the prognosis of hornet sting.Methods A total of 78 patients with hornet sting admitted to the Department of Emergency,the First People’s Hospital of Changde City from April 2019 to March 2023 were enrolled,and they were divided into the good prognosis group and poor prognosis group based on their prognosis.The baseline data,as well as the levels of PIC,t-PAIC,TAT,TM,D-dimer(DD),fibrin degradation products(FDP),prothrombin time(PT),and activated partial thromboplastin time(APTT)were compared between the two groups.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive efficacy of the aforementioned factors on the prognosis of hornet sting.Results The proportion of intravascular hemolysis,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,Sequential Organ Failure Assessment(SOFA)score,number of sting,and lactate level were significantly higher in the poor prognosis group than in the good prognosis group(P<0.05).The plasma levels of TAT,TM,PIC,and t-PAIC were significantly higher in the poor prognosis group than in the good prognosis group(P<0.05).The levels of FDP,DD,APTT,and PT were significantly higher in the poor prognosis group compared to the good prognosis group(P<0.05).PIC,t-PAIC,TAT,and TM were all risk factors for poor prognosis of hornet sting(P<0.05).ROC curve analysis showed that the sensitivity of TAT,TM,PIC,t-PAIC,and their combination in predicting poor prognosis caused by hornet sting was 67.90%,75.00%,53.60%,64.30%,and 89.00%respectively,and the corresponding area under the curve(AUC)was 0.799,0.767,0.690,0.678,and 0.919,respectively.Conclusion The levels of PIC,t-PAIC,TAT,and TM were abnormal in patients with poor prognosis,and their combination had a high early predictive value for poor prognosis caused by hornet sting.
作者
曾宪华
覃双全
刘笋
何熔
罗亚玲
朱首珍
骆立晖
印伟
ZENG Xianhua;QIN Shuangquan;LIU Sun(Department of Emergency,the First People’s Hospital of Changde City,Hunan,Changde 415000,China)
出处
《河北医药》
CAS
2024年第19期2958-2961,共4页
Hebei Medical Journal
基金
常德市科技创新指导性计划项目(编号:2022ZD19)。
关键词
胡蜂蜇伤
活化凝血酶时间
凝血酶原时间
hornet sting
activated partial thromboplastin time
prothrombin time
