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肺炎合并静脉血栓栓塞症患者的凝血和炎症指标:一项倾向评分匹配研究

Coagulation and Inflammatory Indicators in Pneumonia Patients with Venous Thromboembolism: A Propensity-Score Matching Study.

作者信息

Liu Yanhong, Guo Bo, Meng Zhen, Fan Yanru, Xie Yan, Gao Lan, Ma Rufei

机构信息

Department of Laboratory Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, People's Republic of China.

Department of Critical Care Medicine, Henan Key Laboratory for Critical Care Medicine, Zhengzhou Key Laboratory for Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, People's Republic of China.

出版信息

J Inflamm Res. 2025 Apr 25;18:5627-5635. doi: 10.2147/JIR.S514938. eCollection 2025.

Abstract

BACKGROUND

Venous thromboembolism (VTE) is associated with high morbidity and mortality. In recent years, increasing evidence has suggested that inflammation plays a critical role in the pathogenesis of VTE. Patients with pneumonia often exhibit an inflammatory response. This study aimed to investigate the correlation between inflammatory indicators and VTE by analyzing laboratory indicators in patients with pneumonia and VTE.

METHODS

Samples were collected from patients with pneumonia admitted between December 2022 and March 2023. Patients were classified into the VTE and non-VTE groups according to whether they had VTE or not. Propensity score matching (PSM) was performed to control for potential confounding factors. Coagulation and inflammatory indicators were measured. Statistical analyses were performed to identify biomarkers that exhibited significant differences between the two groups, and the relationship between coagulation and inflammatory indicators was further explored.

RESULTS

D-dimer, thrombin-antithrombin complex (TAT), plasmin-α2-antiplasmin complex (PIC), t-PA:PAI-1 complex (tPAIC), and thrombomodulin (TM) levels were significantly higher in the VTE group. White blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), procalcitonin (PCT), and C-reactive protein (CRP) levels were significantly elevated in VTE group. The areas under the curve (AUC) of the receiver operator characteristic (ROC) curves for D-dimer, TAT, PIC, tPAIC, and TM were 0.806, 0.691, 0.656, 0.621, and 0.641, respectively, while the areas for WBC, NLR, CRP, and PCT were 0.690, 0.647, 0.618, and 0.651, respectively. Correlation analysis revealed that WBC was significantly correlated with D-dimer, TAT, PIC and TM. NLR was correlated with D-dimer and TM. CRP was correlated with D-dimer and TM.

CONCLUSION

There is a significant activation of both coagulation and fibrinolytic systems in pneumonia patients. VTE in pneumonia patients is associated with the activation of inflammatory system. Monitoring inflammatory and coagulation indicators in pneumonia patients can facilitate early identification of individuals at an elevated risk of VTE.

摘要

背景

静脉血栓栓塞症(VTE)与高发病率和死亡率相关。近年来,越来越多的证据表明炎症在VTE的发病机制中起关键作用。肺炎患者常表现出炎症反应。本研究旨在通过分析肺炎合并VTE患者的实验室指标,探讨炎症指标与VTE之间的相关性。

方法

收集2022年12月至2023年3月期间收治的肺炎患者样本。根据患者是否发生VTE将其分为VTE组和非VTE组。采用倾向评分匹配(PSM)来控制潜在的混杂因素。检测凝血和炎症指标。进行统计分析以确定两组间存在显著差异的生物标志物,并进一步探讨凝血指标与炎症指标之间的关系。

结果

VTE组的D-二聚体、凝血酶-抗凝血酶复合物(TAT)、纤溶酶-α2-抗纤溶酶复合物(PIC)、组织型纤溶酶原激活物-纤溶酶原激活物抑制剂-1复合物(tPAIC)和血栓调节蛋白(TM)水平显著更高。VTE组的白细胞计数(WBC)、中性粒细胞与淋巴细胞比值(NLR)、降钙素原(PCT)和C反应蛋白(CRP)水平显著升高。D-二聚体、TAT、PIC、tPAIC和TM的受试者工作特征(ROC)曲线下面积(AUC)分别为0.806、0.691、0.656、0.621和0.641,而WBC、NLR、CRP和PCT的AUC分别为0.690、0.647、0.618和0.651。相关性分析显示,WBC与D-二聚体、TAT、PIC和TM显著相关。NLR与D-二聚体和TM相关。CRP与D-二聚体和TM相关。

结论

肺炎患者的凝血和纤溶系统均有显著激活。肺炎患者的VTE与炎症系统激活有关。监测肺炎患者的炎症和凝血指标有助于早期识别VTE风险升高的个体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/598f/12039850/ed0fe1ba71cc/JIR-18-5627-g0001.jpg

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