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APTT 和 D-二聚体可作为重症热相关疾病患者中暑的生物标志物。

APTT and D-dimer as biomarkers for heatstroke in patients with severe heat-related illnesses.

机构信息

Department of Blood Transfusion, Suining Central Hospital, Sichuan, Suining, PR China.

出版信息

Medicine (Baltimore). 2024 Aug 30;103(35):e39493. doi: 10.1097/MD.0000000000039493.

Abstract

The objective of this study was to analyze the changes of activated partial thromboplastin time (APTT) and D-dimer in severe heatstroke (HS) patients and their value in identifying HS patients and to analyze clinical features and early laboratory test results of heat-related illnesses. Forty-five patients with heat-related illnesses who were admitted to the Department of Emergency and Intensive Care Medicine of Suining Central Hospital from June 2022 to April 2023 were retrospectively analyzed. Patients were divided into 3 groups based on their clinical diagnosis: classic HS group, exertional HS group, and control group. General date and laboratory test results were collected, especially APTT and D-dimer. The receiver operating characteristic curve was used to analyze D-dimer and APTT. : There were differences in gender distribution among the 3 groups. Exertional HS was dominated by male patients, and classic HS was dominated by elderly patients. Binary logistic regression analysis of coagulation index showed a significant correlation between D-dimer and APTT and HS. The receiver operating characteristic curve results showed that APTT and D-dimer had high sensitivity and specificity in the identification of HS with an area under the curve (AUC) of 0.846, sensitivity of 97%, and specificity of 58.3% for APTT and an AUC of 0.861, sensitivity of 72%, and specificity of 91.7% for D-dimer (D-dimer + APTT [AUC, 0.929; sensitivity, 81.8%-91.7%; P < .001]). : The mortality rate of HS is high, and early diagnosis is particularly important. APTT and D-dimer may be used as markers assisting in identifying HS.

摘要

本研究旨在分析重型中暑(HS)患者活化部分凝血活酶时间(APTT)和 D-二聚体的变化及其在识别 HS 患者中的价值,并分析与热有关疾病的临床特征和早期实验室检查结果。回顾性分析 2022 年 6 月至 2023 年 4 月期间入住遂宁市中心医院急诊重症医学科的 45 例与热有关疾病的患者。根据临床诊断将患者分为 3 组:经典 HS 组、劳力性 HS 组和对照组。收集一般资料和实验室检查结果,特别是 APTT 和 D-二聚体。采用受试者工作特征曲线分析 D-二聚体和 APTT。结果:3 组之间的性别分布存在差异。劳力性 HS 以男性患者为主,经典 HS 以老年患者为主。凝血指标的二元逻辑回归分析显示,D-二聚体和 APTT 与 HS 显著相关。受试者工作特征曲线结果显示,APTT 和 D-二聚体在识别 HS 方面具有较高的敏感性和特异性,曲线下面积(AUC)分别为 0.846、敏感性 97%和特异性 58.3%,AUC 为 0.861、敏感性 72%和特异性 91.7%(D-二聚体+APTT[AUC,0.929;敏感性,81.8%-91.7%;P<0.001])。结论:HS 的死亡率较高,早期诊断尤为重要。APTT 和 D-二聚体可作为辅助识别 HS 的标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f7/11365662/12a336d9bb35/medi-103-e39493-g001.jpg

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