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Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis.
Clinical and Applied Thrombosis/Hemostasis ( IF 2.3 ) Pub Date : 2022-05-24 , DOI: 10.1177/10760296221102929
Juanzhen Li 1 , Jingyi Zhou 2 , Hong Ren 1 , Teng Teng 1 , Biru Li 1 , Ying Wang 1 , Long Xiang 1, 3
Affiliation  

OBJECTIVE To investigated the clinical efficacy of Soluble thrombomodulin (sTM), tissue plasminogen activator inhibitor complex (t-PAI·C),thrombin-antithrombin complex (TAT),α2-plasmininhibitor-plasmin complex (PIC) in pediatric sepsis and pediatrics sepsis-induced coagulopathy (pSIC). METHODS We prospectively collected patient data with sepsis diagnosed in the PICU of Shanghai Children's Medical Center from June 2019 to June 2021. sTM,t-PAI·C, TAT,PIC and classical coagulation laboratory tests (CCTs) were evaluated on the day of sepsis diagnosis. RESULTS Fifty-nine children were enrolled, There were significant differences in t-PAI·C (P = 0.001), Plt (P < 0.001), PT (P < 0.001), INR (P < 0.001), aPTT (P < 0.001), and TT (P = 0.048) between the pSIC and non-pSIC groups, logistic regression analysis showed that Plt (P = 0.032) was an independent risk factor for pSIC. Logistic regression analysis showed that sTM (P = 0.007) and Plt (P = 0.016) were independent risk factors for the outcome in pediatrics sepsis following discharge. The AUC of sTM combined with Plt on the mortality outcome of children with sepsis at discharge was 0.889 (95%CI: 0.781,0.956). which was better than that for PRISM III (AUC, 0.723), pSOFA (AUC, 0.764), and blood Lac (AUC, 0.717) when sepsis was diagnosed in the PICU. CONCLUSIONS The t-PAI·C increased in children with pSIC. The prediction of sepsis outcome using sTM combined with Plt was better than with PRISM III, pSOFA, or Lac.Further research is still needed in the future to explore the clinical value of sTM, TAT, PIC, and t-PAI·C in diagnosis and outcome of pediatrics sepsis and pSIC.

中文翻译:

可溶性血栓调节素、组织纤溶酶原激活物抑制剂复合物、凝血酶-抗凝血酶复合物、α2-纤溶酶抑制剂-纤溶酶复合物在小儿脓毒症中的临床疗效。

目的探讨可溶性血栓调节蛋白(sTM)、组织纤溶酶原激活物抑制剂复合物(t-PAI·C)、凝血酶-抗凝血酶复合物(TAT)、α2-纤溶酶抑制剂-纤溶酶复合物(PIC)在小儿脓毒症和小儿脓毒症中的临床疗效。诱发凝血病(pSIC)。方法前瞻性收集2019年6月至2021年6月上海市儿童医学中心PICU诊断为脓毒症的患者资料。在脓毒症当天评估sTM、t-PAI·C、TAT、PIC和经典凝血实验室检查(CCTs)。诊断。结果 59名儿童入组,t-PAI·C(P = 0.001)、Plt(P < 0.001)、PT(P < 0.001)、INR(P < 0.001)、aPTT(P < 0.001)有显着差异),以及 pSIC 和非 pSIC 组之间的 TT (P = 0.048),逻辑回归分析显示 Plt (P = 0. 032) 是 pSIC 的独立危险因素。Logistic 回归分析显示,sTM (P = 0.007) 和 Plt (P = 0.016) 是儿科脓毒症出院后预后的独立危险因素。sTM联合Plt对脓毒症患儿出院时死亡率结果的AUC为0.889(95%CI:0.781,0.956)。在 PICU 诊断出脓毒症时,优于 PRISM III (AUC, 0.723)、pSOFA (AUC, 0.764) 和血 Lac (AUC, 0.717)。结论 pSIC患儿的t-PAI·C升高。sTM联合Plt对脓毒症预后的预测优于PRISM III、pSOFA或Lac。未来仍需进一步研究探索sTM、TAT、PIC和t-PAI·C在诊断中的临床价值和儿科脓毒症和 pSIC 的结果。Logistic 回归分析显示,sTM (P = 0.007) 和 Plt (P = 0.016) 是儿科脓毒症出院后预后的独立危险因素。sTM联合Plt对脓毒症患儿出院时死亡率结果的AUC为0.889(95%CI:0.781,0.956)。在 PICU 诊断出脓毒症时,优于 PRISM III (AUC, 0.723)、pSOFA (AUC, 0.764) 和血 Lac (AUC, 0.717)。结论 pSIC患儿的t-PAI·C升高。sTM联合Plt对脓毒症预后的预测优于PRISM III、pSOFA或Lac。未来仍需进一步研究探索sTM、TAT、PIC和t-PAI·C在诊断中的临床价值和儿科脓毒症和 pSIC 的结果。Logistic 回归分析显示,sTM (P = 0.007) 和 Plt (P = 0.016) 是儿科脓毒症出院后预后的独立危险因素。sTM联合Plt对脓毒症患儿出院时死亡率结果的AUC为0.889(95%CI:0.781,0.956)。在 PICU 诊断出脓毒症时,优于 PRISM III (AUC, 0.723)、pSOFA (AUC, 0.764) 和血 Lac (AUC, 0.717)。结论 pSIC患儿的t-PAI·C升高。sTM联合Plt对脓毒症预后的预测优于PRISM III、pSOFA或Lac。未来仍需进一步研究探索sTM、TAT、PIC和t-PAI·C在诊断中的临床价值和儿科脓毒症和 pSIC 的结果。016)是出院后儿科脓毒症结果的独立危险因素。sTM联合Plt对脓毒症患儿出院时死亡率结果的AUC为0.889(95%CI:0.781,0.956)。在 PICU 诊断出脓毒症时,优于 PRISM III (AUC, 0.723)、pSOFA (AUC, 0.764) 和血 Lac (AUC, 0.717)。结论 pSIC患儿的t-PAI·C升高。sTM联合Plt对脓毒症预后的预测优于PRISM III、pSOFA或Lac。未来仍需进一步研究探索sTM、TAT、PIC和t-PAI·C在诊断中的临床价值和儿科脓毒症和 pSIC 的结果。016)是出院后儿科脓毒症结果的独立危险因素。sTM联合Plt对脓毒症患儿出院时死亡率结果的AUC为0.889(95%CI:0.781,0.956)。在 PICU 诊断出脓毒症时,优于 PRISM III (AUC, 0.723)、pSOFA (AUC, 0.764) 和血 Lac (AUC, 0.717)。结论 pSIC患儿的t-PAI·C升高。sTM联合Plt对脓毒症预后的预测优于PRISM III、pSOFA或Lac。未来仍需进一步研究探索sTM、TAT、PIC和t-PAI·C在诊断中的临床价值和儿科脓毒症和 pSIC 的结果。956)。在 PICU 诊断出脓毒症时,优于 PRISM III (AUC, 0.723)、pSOFA (AUC, 0.764) 和血 Lac (AUC, 0.717)。结论 pSIC患儿的t-PAI·C升高。sTM联合Plt对脓毒症预后的预测优于PRISM III、pSOFA或Lac。未来仍需进一步研究探索sTM、TAT、PIC和t-PAI·C在诊断中的临床价值和儿科脓毒症和 pSIC 的结果。956)。在 PICU 诊断出脓毒症时,优于 PRISM III (AUC, 0.723)、pSOFA (AUC, 0.764) 和血 Lac (AUC, 0.717)。结论 pSIC患儿的t-PAI·C升高。sTM联合Plt对脓毒症预后的预测优于PRISM III、pSOFA或Lac。未来仍需进一步研究探索sTM、TAT、PIC和t-PAI·C在诊断中的临床价值和儿科脓毒症和 pSIC 的结果。
更新日期:2022-05-24
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