高级检索

血栓四项联合预测急性白血病伴弥散性血管内凝血患者近期预后的价值

Value of combining four thrombotic markers in predicting short-term prognosis of patients with acute leukemia complicated by disseminated intravascular coagulation

    摘要
  • 摘要:
    目的  探讨血栓四项凝血酶-抗凝血酶复合物(TAT)、组织型纤溶酶原激活物-纤溶酶原激活物抑制剂-1复合物(t-PAIC)、纤溶酶-α2纤溶酶抑制剂复合物(PIC)、血栓调节蛋白(TM)对急性白血病伴弥散性血管内凝血(DIC)患者近期预后的预测价值。
    方法  选取52例急性白血病伴DIC患者作为研究组, 50例单纯急性白血病患者作为对照组，开展前瞻性队列研究。比较2组患者的一般资料及血栓四项(PIC、TAT、TM、t-PAIC)水平; 绘制Kaplan-Meier(KM)生存曲线，分析研究组患者28 d预后情况; 绘制受试者工作特征(ROC)曲线，分析血栓四项对急性白血病伴DIC患者近期预后不良的预测价值。
    结果  研究组血浆TAT、PIC、t-PAIC、TM水平高于对照组，差异有统计学意义(P < 0.05); 研究组患者28 d预后情况为死亡(预后不良)17例、存活(预后良好)35例，预后不良患者入院时血浆TAT、PIC、t-PAIC、TM水平高于预后良好患者，差异有统计学意义(P < 0.05); ROC曲线显示，TAT、PIC、t-PAIC、TM单独预测急性白血病伴DIC患者近期预后不良的曲线下面积(AUC)分别为0.775、0.769、0.767、0.770，血栓四项联合预测的AUC为0.939, 大于各指标单独预测的AUC(Z=1.986、2.014、2.026、2.003，P=0.021、0.010、0.008、0.014)。
    结论  血栓四项(TAT、PIC、t-PAIC、TM)对急性白血病伴DIC患者近期预后具有较高的预测价值，联合检测可为临床预测患者预后提供参考依据。

     

    Abstract:
    Objective  To investigate the predictive value of four thrombotic markersthrombin-antithrombin complex (TAT), tissue-type plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC), plasmin-α2-plasmin inhibitor complex (PIC) and thrombomodulin (TM) for short-term prognosis of patients with acute leukemia complicated by disseminated intravascular coagulation (DIC).
    Methods  A prospective cohort study was conducted. Fifty-two patients with acute leukemia complicated by DIC were selected as study group, and 50 patients with simple acute leukemia were selected as control group. The general data and levels of the four thrombotic markers (PIC, TAT, TM, t-PAIC) were compared between the two groups. The Kaplan-Meier (KM) survival curve was plotted to analyze the 28-day prognosis of the patients in the study group. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the four thrombotic markers for poor short-term prognosis in patients with acute leukemia complicated by DIC.
    Results  The plasma levels of TAT, PIC, t-PAIC and TM in the study group were higher than those in the control group, and the differences were statistically significant (P < 0.05). Among the patients in the study group, there were 17 deaths (poor prognosis) and 35 survival cases (good prognosis) at 28 days. The plasma levels of TAT, PIC, t-PAIC and TM in patients with poor prognosis were higher than those in patients with good prognosis at admission, and the differences were statistically significant (P < 0.05). The ROC curve showed that the area under the curve (AUC) for TAT, PIC, t-PAIC, and TM in predicting poor short-term prognosis in patients with acute leukemia complicated by DIC alone were 0.775, 0.769, 0.767, and 0.770, respectively. The AUC for the combined prediction of the four thrombotic markers was 0.939, which was higher than that for each individual marker (Z=1.986, 2.014, 2.026, 2.003; P=0.021, 0.010, 0.008, 0.014).
    Conclusion  The four thrombotic markers (TAT, PIC, t-PAIC, TM) have a high predictive value for the short-term prognosis of patients with acute leukemia complicated by DIC. Combined detection can provide a reference basis for clinical prognosis prediction in these patients.

     

    • HTML全文
    • 参考文献(19)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回