| Background: The pathogenesis of acute pancreatitis(AP)is related to the disturbance of pancreatic microcirculation.The interaction between inflammation and coagulation is an important pathological process in the occurrence and development of AP.At present,thrombin-antithrombin complex(TAT),plasmin-α2 antiplasmin complex(PIC)and thrombomodulin have been found in domestic and foreign studies(s TM),tissue plasminogen activator-plasminogen activator inhibitor-1 complex(t-PAIC)are associated with acute kidney injury,acute respiratory distress syndrome(ARDS),sepsis and disseminated intravascular coagulation(DIC).However,there is no relevant study on the combined detection of TAT,PIC,s TM and t-PAIC in the evaluation of the severity of patients with acute pancreatitis.Aims: To explore the application value of TAT,PIC,s TM and t-PAIC coagulation-related biomarkers in evaluating the severity of AP,so as to provide earlier reference indicators for the diagnosis and treatment of clinical AP.Methods: A total of 59 AP patients admitted to the Emergency Department of the Second Affiliated Hospital of Nanchang University from June 2022 to March2023 were selected and divided into mild group and severe group according to their severity.There were 43 AP patients in the mild group(MAP)and 16 AP patients in the severe group(10 MSAP patients;Severe AP patients,SAP,6 cases).TAT,PIC,s TM,t-PAIC,D-dimer(D-D),prothrombin time(PT),fibrinogen(Fib),activated partial thrombin time(APTT)and other indexes of the two groups of patients were compared and analyzed.Logistic regression was used to analyze the relationship between each index and the severity of AP.The combined prediction probability of each index is calculated.Receiver operating characteristic(ROC)curve was generated and area under receiver operating characteristic curve(AUC)was calculated.Results: Compared with mild group,TAT,s TM,PT and D-D levels were significantly increased in severe group(p<0.05).There was no significant difference in PIC and t-PAIC levels between the two groups(p<0.05).Multiple Logistic regression analysis showed that TAT and D-D were independent risk factors for MSAP and SAP(p<0.05).ROC curve analysis results showed that the best thresholds of TAT,s TM and D-D to predict MSAP and SAP were 6.28ng/m L,9.51TU/m L and0.83mg/L,respectively,and AUC were 0.722,0.722 and 0.762,respectively.TAT+s TM+D-D combined assay had good efficacy in predicting MSAP and SAP,with an AUC of 0.859,sensitivity and specificity of 81% and 91%,respectively.Conclusions: There are endothelial injury and abnormal activation of coagulation system in MSAP and SAP patients.TAT and s TM have better predictive value for MSAP and SAP patients.Meanwhile,the combined D-dimer detection has higher application value and can be used for early prediction of MSAP and SAP. |
