Fidan Sami, Erkut Murat, Cosar Arif Mansur, Yogun Yasar, Örem Asım, Sönmez Mehmet, Arslan Mehmet
Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Department of Gastroenterology, Gebze Fatih State Hospital, Kocaeli, Turkey.
Dig Dis. 2018;36(3):244-251. doi: 10.1159/000485613. Epub 2018 Jan 12.
Coagulation disorders may develop in association with severe acute pancreatitis (AP). Plasma thrombin-antithrombin III complex (TAT) levels are one of the principal markers of coagulation disorder. The purpose of this study was to evaluate TAT and other hemostatic parameters in patients with AP and to examine whether or not these parameters indicate the severity of AP.
Forty-six patients with AP (14 severe, 32 non-severe) and a 30-member healthy control group were recruited. The severity of AP was determined using the revised Atlanta classification. ELISA was used to measure patients' plasma TAT levels.
The TAT levels of AP patients at presentation were higher than those of the control group (p = 0.005). The plasma TAT levels of patients with severe AP were also significantly higher than those of patients with non-severe AP (p = 0.05) and of the control group (p < 0.001). The general accuracy, sensitivity and specificity of TAT levels in predicting the severity of AP were 77.4, 77.8, and 77.3% respectively.
The coagulation cascade was activated in the AP patients in our study, and this was shown to become more pronounced as severity of the disease increased. Plasma TAT levels at the time of presentation in patients with AP can be used as a marker for predicting the severity of the disease.
凝血功能障碍可能与重症急性胰腺炎（AP）相关。血浆凝血酶 - 抗凝血酶III复合物（TAT）水平是凝血功能障碍的主要标志物之一。本研究旨在评估AP患者的TAT及其他止血参数，并探讨这些参数是否能指示AP的严重程度。
招募了46例AP患者（14例重症，32例非重症）和一个由30名成员组成的健康对照组。采用修订的亚特兰大分类法确定AP的严重程度。采用酶联免疫吸附测定法（ELISA）测量患者血浆TAT水平。
AP患者就诊时的TAT水平高于对照组（p = 0.005）。重症AP患者的血浆TAT水平也显著高于非重症AP患者（p = 0.05）和对照组（p < 0.001）。TAT水平预测AP严重程度的总体准确性、敏感性和特异性分别为77.4%、77.8%和77.3%。
在我们的研究中，AP患者的凝血级联反应被激活，并且随着疾病严重程度的增加，这种激活表现得更加明显。AP患者就诊时的血浆TAT水平可作为预测疾病严重程度的标志物。
