Department of Clinical Laboratory, Institute of Translational Medicine, Renmin Hospital of Wuhan University, Wuhan, PR China.
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241257517. doi: 10.1177/10760296241257517.
Early identification of biomarkers that can predict the onset of sepsis-induced coagulopathy (SIC) in septic patients is clinically important. This study endeavors to examine the diagnostic and prognostic utility of serum C1q in the context of SIC. Clinical data from 279 patients diagnosed with sepsis at the Departments of Intensive Care, Respiratory Intensive Care, and Infectious Diseases at the Renmin Hospital of Wuhan University were gathered spanning from January 2022 to January 2024. These patients were categorized into two groups: the SIC group comprising 108 cases and the non-SIC group consisting of 171 cases, based on the presence of SIC. Within the SIC group, patients were further subdivided into a survival group (43 cases) and non-survival group (65 cases). The concentration of serum C1q in the SIC group was significantly lower than that in the non-SIC group. Furthermore, A significant correlation was observed between serum C1q levels and both SIC score and coagulation indices. C1q demonstrated superior diagnostic and prognostic performance for SIC patients, as indicated by a higher area under the curve (AUC). Notably, when combined with CRP, PCT, and SOFA score, C1q displayed the most robust diagnostic efficacy for SIC. Moreover, the combination of C1q with the SOFA score heightened predictive value concerning the 28-day mortality of SIC patients.
早期识别能够预测脓毒症相关性凝血功能障碍(SIC)发生的生物标志物对于脓毒症患者的临床诊治具有重要意义。本研究旨在探讨血清 C1q 在 SIC 中的诊断和预后价值。研究收集了 2022 年 1 月至 2024 年 1 月武汉大学人民医院重症医学科、呼吸重症医学科和感染科诊断为脓毒症的 279 例患者的临床资料。根据是否存在 SIC,将这些患者分为 SIC 组(n=108)和非 SIC 组(n=171)。在 SIC 组中,根据患者的生存状况,进一步分为生存组(n=43)和非生存组(n=65)。SIC 组患者血清 C1q 浓度明显低于非 SIC 组。此外,血清 C1q 水平与 SIC 评分和凝血指标均呈显著负相关。C1q 对 SIC 患者的诊断和预后具有较高的价值,曲线下面积(AUC)较大。值得注意的是,与 CRP、PCT 和 SOFA 评分联合应用时,C1q 对 SIC 的诊断效能最高。此外,C1q 联合 SOFA 评分可提高 SIC 患者 28 天死亡率的预测价值。