Coagulation function and prognosis assessment in patients with acute organophosphorus poisoning

CAO Qian; CHAO Yan-yan

doi:10.13820/j.cnki.gdyx.20184289

Abstract：Objective To investigate the coagulation function in patients with acute organophosphorus poisoning and to evaluate the prognosis.Methods Sixty-two patients with acute organophosphate poisoning were selected. According to the national diagnostic criteria of acute organophosphate poisoning and diagnostic criteria, they were divided into mild group (17 cases) and medium restructuring group (45 cases). According to the prognosis, they were divided into survival group (39 cases) and death group (23 cases). TEG testing and prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-dimer (D-D), fibrin The (original) degradation product (FDP) were tested for routine coagulation parameters and the prognostic coagulation function was assessed on all patients. Results Compared with the control group and the mild group, the PT, APTT, and TT were significantly prolonged (P＜0.05), and the D-D and FDP levels were significantly increased (P＜0.05). There was no significant difference in FIB between the reconstituted and control groups (P＞0.05). PT, APTT, and TT in the death group were significantly longer than those in the survival group (P＜0.05). FIB level was significantly lower (P＜0.05), and D-D and FDP levels were significantly higher in the death group were significantly longer than those in the survival group (P＜0.05). With the increase in the degree of poisoning in patients with acute organophosphate poisoning, the K value and R value of the patients were significantly increased (P＜0.05), and the angles of Angle, MA, and CI were significantly reduced (P＜0.05). Compared with the survival group, the K and R values in the death group were significantly higher (P＜0.05), and Angle, MA, and CI values were significantly reduced (P＜0.05). The R value of TEG was positively correlated with PT and APTT (r=0.623 an 0.495, P=0.014 and 0.031). The K value was significantly positively correlated with PT and APTT (r=-0.493, 0.641, P=0.038, 0.011). There was a significantly negative correlation between K value and FIB (r=-0.435, P=0.039). Angle was significantly negatively correlated with PT, APTT an D-D (r=-0.549, -0.561 and-0.443, P=0.028, 0.025 and 0.035), and postively correlated with FIB (r=0.572, P=0.017). MA was significantly positively correlated with FIB (r=0.613, P=0.020). CI was significantly negatively correlated with APTT (r=-0.416, P=0.041), positively correlated with FIB (r=0.473, P=0.032). Conclusion With the increase of the degree of poisoning in patients with acute organophosphate poisoning, the coagulation function shows a hypocoagulated status with bleeding tendency. The TEG detection index has a certain correlation with the conventional coagulation index. Through the TEG test, it is helpful to monitor the coagulation state of patients with acute organophosphate poisoning, and guide the clinical intervention of patients with early coagulation dysfunction.