The diagnostic value of plasma t-PAIC in heat stroke-induced coagulopathy

He Longping; Zhong Lincui; Yu Yongchun; Lin Qingwei; Zhou Ye; Peng Enlan; Song Jingchun

doi:10.3969/j.issn.1002-1949.2024.06.010

Abstract：Objective To investigate the clinical value of tissue-type fibrinolytic activator-inhibitor complex(t-PAIC)in the diagnosis of heat stroke-induced coagulopathy(HIC).Methods We retrospectively analyzed 65 patients with heat stroke admitted to the Department of Critical Care Medicine of No.908th Hospital of Joint Logistic Support Force of Chinese PLA from May 2018 to September 2023.According to the severity of heat stroke,they were divided into heat exhaustion(HE)group(n=32),non-heat stroke coagulopathy(nHIC)group(n=13),and HIC group(n=20).The changes of t-PAIC levels among the three groups were compared,Spearman correlation analysis was used to evaluate the correlation of t-PAIC with the lactic acid level and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ),and receiver operating characteristic(ROC)curves were drawn to evaluate the diagnostic value of t-PAIC for HIC.Results Compared with the t-PAIC level in the HE group,the t-PAIC level in the nHIC group and the HIC group were significantly increased[ng/mL:2.69(1.46-5.07)vs.8.70(3.99-20.41)and 21.99(12.36-43.27),P＜0.05],and the t-PAIC level of the HIC group was significantly higher than that of the nHIC group(P＜0.05).Spearman correlation analysis showed that the lactic acid level and APACHE Ⅱ score in heat stroke patients were positively correlated with t-PAIC level(correlation coefficient r was 0.500 and 0.645,P＜0.001).The area under the ROC curve for t-PAIC in diagnosing HIC was 0.843(P＜0.05);when the t-PAIC cut-off value was 11.43 ng/mL,the sensitivity was 80.0％and the specificity was 82.2％.Conclusions The plasma t-PAIC level is correlated with the severity of heat stroke,and can be used as a molecular marker for the diagnosis of HIC.