Evaluation the combined diagnostic value of TAT, PIC, tPAIC, and sTM in disseminated intravascular coagulation: A multi-center prospective observational study
Evaluation the combined diagnostic value of TAT, PIC, tPAIC, and sTM in disseminated intravascular coagulation: A multi-center prospective observational study
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评价TAT、PIC、tPAIC和sTM联合诊断弥散性血管内凝血的价值：一项多中心前瞻性观察研究
DOI：
10.1016/j.thromres.2018.11.010
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发表时间：
2019-01-01
影响因子：
7.5
通讯作者：
Hu, Yu
中科院分区：
文献类型：
--
作者：
Mei, Heng;Jiang, Ying;Hu, Yu
背景：准确和早期诊断在弥散性血管内凝血（DIC）的治疗中非常重要。我们采用自动化技术检测血浆生物标志物，包括凝血酶-抗凝血酶复合物（达特）、α 2-纤溶酶原激活物-纤溶酶复合物（PIC）、可溶性血栓调节蛋白（sTM）和组织型纤溶酶原激活物-抑制物复合物（tPAIC），并评价它们在中国人群DIC中的诊断性能和预后价值。这项前瞻性观察性研究包括444名疑似DIC患者和137名健康人。采用HISCL全自动化学发光酶免疫分析仪进行定性检测。所有疑似DIC的患者随访7天，以筛选发展为显性DIC和28天的mortals.Results：根据国际血栓形成和止血学会（ISTH）评分系统，157例被诊断为显性DIC和36例被诊断为前DIC。DIC患者的所有四种生物标志物均显著高于非显性DIC患者; DIC前患者的达特、tPAIC和sTM显著高于非显性DIC患者。四种分子标记在不同基础疾病中的表现不同。达特，tPAIC，和sTM也是28天死亡率的良好预测因子，高水平与不良outcomes.Conclusions：达特，PIC，tPAIC，和sTM表现出良好的诊断性能和预后价值DIC患者与不同的基础疾病。达特、tPAIC、sTM在DIC前期有一定意义。四种标记物组合比单一标记物表现出更好的行为。
Background: Accurate and early diagnosis is important in the management of disseminated intravascular coagulation (DIC). We employed new automation technology to detect plasma biomarkers, including thrombin-antithrombin complex (TAT), alpha 2-plasmininhibitor-plasmin complex (PIC), soluble thrombomodulin (sTM), and tissue plasminogen activator-inhibitor complex (tPAIC), and evaluated their diagnostic performance and prognostic value for DIC in Chinese population.Methods: This prospective observational study included 444 patients with suspected DIC and 137 healthy people. 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 the development of overt-DIC and 28 days for mortality.Results: According to the International Society of Thrombosis and Haemostasis (ISTH) scoring system, 157 patients were diagnosed as overt-DIC and 36 were diagnosed as pre-DIC. All four biomarkers were significantly higher in DIC patients than in non-overt DIC patients; TAT, tPAIC, and sTM were significantly higher in pre-DIC patients than in non-overt DIC patients. Four molecular markers behaved differently among various underlying diseases. TAT, tPAIC, and sTM were also good predictors of 28-day mortality, high levels were associated with poor outcomes.Conclusions: TAT, PIC, tPAIC, and sTM demonstrated good diagnostic performance and prognostic value in DIC patients with different underlying diseases. Besides, TAT, tPAIC and sTM have certain implications in pre-DIC stage. Combination of four makers was demonstrated better behavior than single one.