BAO Xiao-wei,WANG Xuan,JIN Ning,et al.Serum TM, TAT, PIC and t-PAIC levels in early diagnosis of septic DIC[J].同济大学学报（医学版）,2021,42(3):327-332，342. [点击复制]
Serum TM, TAT, PIC and t-PAIC levels in early diagnosis of septic DIC
BAO Xiao-wei,WANG Xuan,JIN Ning,SUN Hong,YANG Qian,REN Hui-juan,LIU Xian-dong,JIN Chen-ying,TANG Lun-xian
(Dept. of Emergency Internal Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China;Clinical Laboratory, South Campus of Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200123, China)
Abstract:
ObjectiveTo evaluate the value of serum levels of thrombomodulin（TM), thrombin-antithrombin complex（TAT), plasminogen antifibrinolytic complex（PIC) and tissue plasminogen activator plasminogen activator inhibitor complex（t-PAIC) in early diagnosis of disseminated intravascular coagulation（DIC) induced by sepsis. MethodsA total of 80 septic patients admitted to the EICU and GICU in Shanghai East Hospital from January 2017 to December 2019 were enrolled, including 28 cases with septic DIC（DIC group) and 52 cases without DIC（non-DIC group) according to ISTH diagnostic criteria; and 40 healthy subjects were also enrolled as the control group. The blood samples were collected at d1, d3 and d7 after onset of sepsis. The serum levels of TM, TAT, PIC and t-PAIC were determined with chemiluminescent immunoassay at different time points. The receiver operating characteristic curves（ROCs) of TM, TAT, PIC and t-PAIC in septic DIC group were generated, and the areas under the curve（AUC) for early diagnosis of DIC were determined. Pearson correlation analysis of TM, TAT, PIC, t-PAIC with SOFA and APACHEⅡ scores was performed. ResultsSerum TM, PIC and t-PAIC levels in the septic group at d1, 3 and 7 were significantly higher than those in the non-DIC group and the healthy control group（P<0.05). The AUC of the combined detection of TM, PIC and t-PAIC were 0.893, 0.932 and 0.898 on day 1, day 3 and day 7, and the sensitivity and specificity reached 98% and 97.2% on day 3, respectively. Interestingly, there were no significant correlations between the levels of TM, TAT, PIC, t-PAIC in septic DIC group with SOFA and APACHEⅡ scores(P>0.05). ConclusionThe serum levels of TM, PIC and t-PAIC have early diagnostic value for sepsis-induced DIC. Furthermore, the combination of these three biomarkers have superior value than each one of them. But they could not evaluate the severity of illness and prognosis in these patients.
