TAT、PIC、TM、t-PAIC四种分子标志物在弥散性血管内凝血早期诊断中的价值

doi:10.3969/j.issn.0253-2778.2020.04.012

中国科学技术大学学报 ›› 2020, Vol. 50 ›› Issue (4): 474-478.DOI: 10.3969/j.issn.0253-2778.2020.04.012

TAT、PIC、TM、t-PAIC四种分子标志物在弥散性血管内凝血早期诊断中的价值

蒋冬雪，翟志敏

安徽医科大学第二附属医院血液科，安徽合肥 230601

收稿日期:2019-11-26 修回日期:2020-04-20 接受日期:2020-04-20 出版日期:2020-04-30 发布日期:2020-04-20
通讯作者: 翟志敏
作者简介:蒋冬雪，女，1994年生，硕士生.研究方向：内科学（血液系病）.E-mail:2320966607@qq.com
基金资助:
安徽省高校自然科学研究重大项目（KJ2014Z017）资助.

The value of coagulation molecular markers TAT, PIC, TM and t-PAIC in early diagnosis of DIC

JIANG Dongxue, ZHAI Zhimin

Department of Hematology,the Second Hospital of Anhui Medical University,Hefei 230601,China

Received:2019-11-26 Revised:2020-04-20 Accepted:2020-04-20 Online:2020-04-30 Published:2020-04-20

摘要/Abstract

摘要： 目的探讨分子标志物凝血酶-抗凝血酶复合物（thrombin-antithrombin complex，TAT）、血栓调节蛋白（thrombomdulin,TM)、纤溶酶-α2纤溶酶抑制剂复合物（α2-plamininhibitor-plasmin complex，PIC）、组织型纤溶酶原激活剂-抑制剂复合物（tissue plaminogen antivator inhibitor complex,t-PAIC)在弥散性血管内凝血（disseminated intrascular coagulation,DIC)中的早期诊断价值.方法纳入233例有出血倾向或血栓患者的临床病例资料，根据2017年版中国DIC诊断积分系统（CDSS），分为显性DIC组、前DIC组和非DIC组，采用新的自动化技术检测实验室指标，包括TAT、TM、PIC、t-PAIC，比较各组间实验室指标的差异，评估其在DIC早期诊断中的价值.结果在显性DIC患者中，TAT、TM、PIC水平显著高于非DIC患者，t-PAIC在两组中无统计学意义；在前DIC患者中，TAT、TM、PIC、t-PAIC水平显著高于非DIC患者；ROC曲线显示，TAT、TM、PIC及t-PAIC联合诊断曲线下面积为0.887，联合凝血酶原时间（prothomin time，PT）、活化部分凝血活酶时间（activated partial thromboplastin time，APTT）、D-二聚体（D-dimer ，D-D）可达最大曲线下面积为0.933.结论 TAT、TM、PIC及t-PAIC联合检测可提高DIC早期诊断率，为临床早期干预和治疗提供最佳时机.

关键词: 弥散性血管内凝血, 凝血酶-抗凝血酶复合物, 血栓调节蛋白, 纤溶酶-α2纤溶酶抑制剂复合物, 组织型纤溶酶原激活剂-抑制剂复合物

Abstract: Objective To explore the clinical significance of thrombin molecular marker in disseminated intrascular coagulation (DIC), which include thrombin-antithrombin complex (TAT), thrombomodulin (TM), plasmin-antiplasmin inhibitor complex (α2-plamininhibitor-plasmin complex,PIC) and tissue plasminogen activator inhibitor complex (t-PAIC) .Methods This study included 233 patients with bleeding tendency or thrombosis, according to the 2017 edition of the Chinese disseminated intravascular coagulation diagnostic score system (CDSS),who were divided into the dominant DIC group, pre-DIC group and non-DIC group. The differences in laboratory indicators between groups were compared, and its value in the early diagnosis of DIC was evaluated.The molecular markers were measured by qualitative chemiluminescence enzyme immunoassay performed on HISCL automated analyzers.All patients with suspected DIC were followed for 7 days to screen for development of overt-DIC.Results In patients with overt-DIC, TAT, TM, PIC were significantly higher than those in non-DIC patients, and t-PAIC was statistically insignificant between the overt-DIC and non-DIC groups. TAT, TM, PIC, t-PAIC levels were significantly higher in patients with pre-DIC than in non-DIC patients.The AUC shows that the combined diagnostic curve of TAT, TM, PIC, and t-PAIC is 0.887,and AUC combined PT, APTT, and D-D is 0.933.Conclusions The combination of TAT, TM, PIC and t-PAIC can improve the early diagnosis rate of DIC and provide optimal timing for early clinical intervention and treatment.

Key words: disseminated intrascular coagulation（DIC）, thrombin-antithrombin complex（TAT）, thrombomdulin（TM）, α2-plamininhibitor-plasmin complex（PIC）, tissue plaminogen antivator inhibitor complex（t-PAIC）

中图分类号:

R554.8

蒋冬雪，翟志敏. TAT、PIC、TM、t-PAIC四种分子标志物在弥散性血管内凝血早期诊断中的价值[J]. 中国科学技术大学学报, 2020, 50(4): 474-478.

JIANG Dongxue, ZHAI Zhimin. The value of coagulation molecular markers TAT, PIC, TM and t-PAIC in early diagnosis of DIC[J]. Journal of University of Science and Technology of China, 2020, 50(4): 474-478.

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TAT、PIC、TM、t-PAIC四种分子标志物在弥散性血管内凝血早期诊断中的价值

The value of coagulation molecular markers TAT, PIC, TM and t-PAIC in early diagnosis of DIC

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