| 刘妮,姜慧英,王鹏飞,等.血浆 PAP、TM、t-PAIC表达预测脓毒症 102例预后效能[J].安徽医药,2025,29(3):565-569. |
| 血浆 PAP、TM、t-PAIC表达预测脓毒症 102例预后效能 |
| The efficacy of plasma fibrinolytic enzyme α2-antiplasmin complex, thrombomodulin, and tissue plasminogen activator-inhibitor 1 complex in predicting the prognosis of 102 cases of sepsis |
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| DOI：10.3969/j.issn.1009-6469.2025.03.026 |
| 中文关键词: 脓毒症 决策曲线 纤溶酶 α2抗纤溶酶复合物 凝血酶调节蛋白 组织纤溶酶原激活剂 -抑制剂 1复合物 预后 预测 |
| 英文关键词: Sepsis Decision curve Fibrinolytic enzyme α2-antiplasmin complex Thrombomodulin Tissue plasminogen acti-vator-inhibitor 1 complex Prognosis Forecast |
| 基金项目:北京京煤集团总医院院级科研自主项目( ZZ2024-05) |
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| 中文摘要: |
| 目的探讨纤溶酶 α2抗纤溶酶复合物( PAP)、凝血酶调节蛋白( TM)、组织纤溶酶原激活剂 -抑制剂 1复合物( t-PAIC)表达对脓毒症预后的预测价值。方法选取北京京煤集团总医院 2020年 6月至 2022年 12月收治的 102例脓毒症病人，根据 28 d生存预后分为死亡组( n=28)、存活组( n=74)，比较两组一般资料及入院第 1天、第 3天、第 7天血浆 PAP、TM、t-PAIC表达、血清降钙素原( PCT)、白细胞介素( IL)-6，采用 logistic回归方程筛选脓毒症预后的影响因素，采用危险度分析不同血浆 PAP、TM、 t-PAIC表达对脓毒症预后的影响，采用受试者操作特征曲线( ROC曲线)、决策曲线进行效能分析。结果两组急性生理学和慢性健康状况评价 Ⅱ(APACHE Ⅱ)评分、序贯器官衰竭评估( SOFA)评分、弥散性血管内凝血比较，差异有统计学意义( P<0.05)；死亡组入院第 1天、第 3天、第 7天血浆 PAP［(7.02±2.11)mg/L、(6.11±1.83)mg/L、(4.89±1.45)mg/L］、 TM［(26.63±7.98)TU/ mL、(23.38±7.01)TU/mL、(21.15±6.34)TU/mL］、 t-PAIC［( 24.42±7.30)μg/L、(20.22±6.06)μg/L、(17.96±5.38)μg/L］及血清 PCT、 IL-6表达高于存活组［( 4.88±1.46)μg/L、(4.30±1.28)μg/L、(3.41±1.03)μg/L，(18.22±5.47)TU/mL、(16.37±4.91)TU/mL、(14.70±4.43)TU/mL，(17.02±5.11)μg/L、(13.98±4.20)μg/L、(12.55±3.77)μg/L］(P<0.05)； logistic回归显示， APACHE Ⅱ评分、 SOFA评分及入院第 1天血浆 PAP、TM、t-PAIC、PCT、IL-6是脓毒症预后的高危因素( P<0.05)；危险度分析显示，入院第 1天血浆 PAP、TM、 t-PAIC高表达病人死亡风险是低表达的 1.987、2.404、3.133倍( P<0.05)； ROC曲线、决策曲线显示，入院第 1天血浆 PAP、TM、t-PAIC表达联合预测脓毒症预后的曲线下面积、净收益率优于单独预测。结论血浆 PAP、TM、t-PAIC高表达是脓毒症预后不良的高危因素，且以上指标联合预测脓毒症预后具有较好价值参考和临床效用。 |
| 英文摘要: |
| Objective To explore the predictive value of plasminogen α2 anti-plasminase complex (PAP), thrombomodulin (TM) and tissue plasminogen activator -inhibitor 1 complex (t-PAIC) in the prognosis of sepsis.Methods A total of 102 patients with sepsis ad-mitted to the Beijing Jingmei Group General Hospital from June 2020 to December 2022 were selected and assigned into a death group(n=28) and a survival group (n=74) according to their 28-day survival prognosis. The general data and the expression levels of plasma PAP, TM, t-PAIC, serum procalcitonin (PCT), interleukin (IL)-6 on the first, third, and seventh days of admission were compared be-tween the two groups. The logistic regression equation was used to screen the factors affecting the prognosis of sepsis. The risk analysiswas used to analyze the impact of different plasma PAP, TM, t-PAIC expressions on the prognosis of sepsis. The receiver operating char-acteristic (ROC) curve and decision curve were used for efficacy analysis. Results There were significant differences in the acutephysiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, the sequential organ failure assessment (SOFA) score, and disseminat-ed intravascular coagulation between the two groups (P<0.05). On the first, third, and seventh days of admission, the death group hadhigher plasma PAP [(7.02±2.11) mg/L, (6.11±1.83) mg/L, (4.89±1.45) mg/L], TM [(26.63±7.98) TU/mL, (23.38±7.01) TU/mL, (21.15±6.34) TU/mL], t-PAIC [(24.42±7.30) μg/L, (20.22±6.06) μg/L, (17.96±5.38) μg/L], and serum PCT and IL-6 expression levels than thesurvival group [(4.88±1.46) μg/L, (4.30±1.28) μg/L, (3.41±1.03) μg/L, (18.22±5.47) TU/mL, (16.37±4.91) TU/mL, (14.70±4.43) TU/mL, (17.02±5.11) μg/L, (13.98±4.20) μg/L, and (12.55±3.77) μg/L, respectively] (P<0.05). Logistic regression analysis results showed that APACHE Ⅱ score, SOFA score, and plasma PAP, TM, t-PAIC, PCT, and IL-6 on the first day of admission were high-risk factors for sepsis prognosis (P<0.05). The risk analysis results showed that the mortality risks of patients with high expression levels of plasma PAP, TM, and t-PAIC on the first day of admission were 1.987, 2.404, and 3.133 times, which were higher than those of patients with |
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