Correlation of TAT,TM,PIC,and t-PAIC with DIC in Patients with Se-vere Hematotoxic Venomous Snake Bite Poisoning and Their Predictive Value
QIN Shuangquan
ZENG Xianhua
LIU Sun
HE Rong
LUO Yaling
ZHU Shouzhen
LUO Lihui
YIN Wei
Abstract：Objective To evaluate the clinical correlation of thrombin anticoagulase complex(TAT),thrombomodu-lin(TM),plasmin antiplasmin complex(PIC)and tissue plasminogen activation inhibition complex(t-PAIC)with dissemi-nated intravascular coagulation(DIC)after severe hematotoxic venomous snake bite poisoning and their predictive value.Methods A total of 132 patients with severe hematotoxic venomous snake bite poisoning admitted from April 2019 to April 2023 were included as the research subjects.According to presence of DIC during hospitalization,the patients were divided into observation group(occurrence of DIC,n=37)and control group(occurrence of DIC,n=95).Plasma concentrations of TAT,TM,PIC and t-PAIC in the two groups were detected.The clinical correlation between the concentrations of TAT,TM,PIC and t-PAIC and DIC after severe hematotoxic venomous snake bite poisoning was analyzed by binary,noncategorical,un-conditioned Logistic regression analysis.Receiver operating characteristic(ROC)curve was established to analyze the predic-tive ability of TAT,TM,PIC and t-PAIC for DIC after severe hematotoxic venomous snake bite poisoning.Results TAT,TM,PIC and t-PAIC in observation group were significantly higher than those in control group(P＜0.05).Binary,uncondi-tioned Logistic regression analysis without classified covariates showed that TAT[OR=1.517(95%CI:1.155,1.879)],TM[OR=1.647(95%CI:1.108,2.186)],PIC[OR=3.989(95%CI:2.986,4.992)]and t-PAIC[OR=1.111(95%CI:0.854,1.368)]were risk factors for DIC in patients with severe hematotoxic venomous snake bite poisoning(P＜0.05).ROC curve analysis showed that TAT,TM,PIC and t-PAIC were effective indicators for predicting DIC in patients with severe hematotoxic venomous snake bite poisoning(P＜0.05),and the area under the curve(AUC)of the above indica-tors was 0.865(95%CI:0.790,0.939),0.771(95%CI:0.673,0.870),0.847(95%CI:0.804,0.889),and 0.680(95%CI:0.573,0.787),respectively,and the combined prediction efficiency was better(P＜0.001),with the AUC of 0.904(95%CI:0.875,0.933).Conclusion TAT,TM,PIC and t-PAIC detection have important reference value in jud-ging whether DIC occur in patients with severe hematotoxic venomous snake bite poisoning,and can better evaluate the status of patients'coagulation function,and the combined detection of the four indicators is more effective in predicting DIC.
Keywords：Snake bitesHematotoxinPoisoningThrombin-antithrombin complexThrombomodulinPlasmin anti-plasmin complexTissue plasminogen activator inhibitor complexDisseminated intravascular coagulation
Publication Date：2024-08-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 51-56 )