凝血酶-抗凝血酶复合物、血栓调节蛋白和组织型纤溶酶原激活物抑制物复合物对危重型新型冠状病毒感染的诊断价值  

Research on diagnostic value of thrombin-antithrombin complex,thrombomodulin and tissue plasminogen activator-inhibitor complex for COVID-19

作　　者：高凤威 周琳 邵小宝 王华[1] 杨圆 陈鑫[1] 刘艺[1] 朱培元 GAO Fengwei;ZHOU Lin;SHAO Xiaobao;WANG Hua;YANG Yuan;CHEN Xin;LIU Yi;ZHU Peiyuan(Department of Transfusion Medicine,Nanjing Hospital of Chinese Medicine Afiliated to Nanjing University of Chinese Medicine,Nanjing 210022,Jiangsu,China)

机构地区：[1]南京中医药大学附属南京市中医院输血科,南京210022

出　　处：《临床检验杂志》2024年第10期748-753,共6页Chinese Journal of Clinical Laboratory Science

摘　　要：目的探讨凝血酶-抗凝血酶复合物(TAT)、血栓调节蛋白(TM)和组织型纤溶酶原激活物抑制物复合物(t-PAIC)对危重型新型冠状病毒感染(COVID-19)的诊断价值。方法回顾性纳入79例COVID-19确诊患者,根据病情严重程度分为非危重型(n=51)和危重型(n=28)2组。比较2组患者凝血功能和炎症指标的差异,分析TAT、TM和t-PAIC与其他生物标志物的相关性,并评估其对危重型COVID-19的诊断价值。结果与非危重型患者相比,危重型患者的TAT、TM和t-PAIC水平显著升高(P<0.001)。TAT、TM和t-PAIC与多项生物标志物呈正相关,其中TAT与D-二聚体的相关性最强(r=0.786,P<0.001)。二元Logistic回归分析显示,TAT(OR=1.346,P<0.05)和t-PAIC(OR=1.128,P<0.05)是危重型COVID-19的独立危险因素。TAT、TM和t-PAIC联合诊断危重型COVID-19的ROC曲线下面积(AUC^(ROC))为0.918,诊断敏感性为75%,特异性为94.1%。结论联合检测TAT、TM和t-PAIC可有效辅助诊断危重型COVID-19,对评估患者病情严重程度和预后具有重要临床意义。Objective To retrospectively analyze the diagnostic value of thrombin-antithrombin complex(TAT),thrombomodulin(TM),and tissue plasminogen activator-inhibitor complex(t-PAIC)in severe cases of corona virus disease 2019(COVID-19).Methods A cohort of 79 patients clinically diagnosed with COVID-19 was retrospectively assembled and categorized into two groups based on disease severity:non-severe(n=51)and severe(n=28).In this study the differences of coagulation function and inflamma-tory marker levels between the two groups were compared.The correlations of TAT,TM and t-PAIC with other biomarkers were investi-gated.The diagnostic values of all the markers for severe COVID-19 were assessed.Results The patients of severe COVID-19 exhibi-ted significantly higher levels of TAT,TM,and t-PAIC compared to those of non-severe group(P<0.001).The levels of TAT,TM and t-PAIC showed notable positive correlation with other biomarkers.TAT demonstrated the strongest positive correlation with the level of D-dimer(r=0.786,P<0.001).Binary logistic regression analysis identified TAT(OR=1.346,P<0.05)and t-PAIC(OR=1.128,P<0.05)were independent risk factors in term of severe COVID-19.The combined ROC curve for TAT,TM and t-PAIC revealed high diagnostic efficacy in severe cases with the area under the curve(AUC^(ROC))were 0.918,and the sensitivity and specificity were of 75%and 94.1%,respectively.Conclusion The results of combined measurement of TAT,TM and t-PAIC effectively demonstrates its diagnostic value in identifying severity and stratification of COVID-19 cases and may have important clinical significance for assessment of the severity and prediction of the prognosis.

关 键 词：新型冠状病毒肺炎 危重型 凝血酶-抗凝血酶复合物 血栓调节蛋白 组织型纤溶酶原激活物抑制物复合物 

分 类 号：R446[医药卫生—诊断学]