Plasmin-α2-plasmin inhibitor complex and thrombin-antithrombin complex in risk stratification of massive transfusion in patients with postpartum hemorrhage
10.13303/j.cjbt.issn.1004-549x.2023.12.010
- VernacularTitle:纤溶酶-α2-纤溶酶抑制剂复合物和凝血酶-抗凝血酶复合物在产后出血患者大量输血风险分层中的作用
- Author:
Yuan ZHAO
1
;
Yaling WANG
1
;
Chunzhi YU
1
Author Information
1. Department of Obstetrics, Northwest Women and Children′s Hospital, Xi′an 710061, China
- Publication Type:Journal Article
- Keywords:
plasmin-α2-plasmin inhibitor complex(PIC);
thrombin-antithrombin complex(TAT);
postpartum hemorrhage;
massive transfusion
- From:
Chinese Journal of Blood Transfusion
2023;36(12):1123-1127
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To analyze the value of plasmin-α2-plasmin inhibitor complex (PIC) and thrombin-antithrombin complex (TAT) for risk stratification of massive transfusion (MT) in patients with postpartum hemorrhage (PPH). 【Methods】 Clinical data and blood samples of patients with PPH in our hospital from January 2019 to December 2022 were retrospectively analyzed. MT (MT group, n=60) was defined as transfusion of red blood cells≥10 U within 24 h after delivery, and <10 U was defined as non-MT group (n=190). Plasma PIC and TAT levels were detected by chemiluminescence immunoassay at the onset of PPH. 【Results】 Compared with non-MT group, PPH patients in MT group had higher TAT [2.20 (1.20, 3.00) ng/mL vs 4.00 (2.20, 6.30) ng/mL, Z=-5.464, P<0.001] and PIC [0.99 (0.82, 1.13) μg/mL vs 1.11 (1.05, 1.55) μg/mL, Z=-7.228, P<0.001] level. The analysis of receiver operator characteristic curve showed that the area under the curve required for MT after TAT and PIC combined to predict PPH was 0.820 (95% CI: 0.756-0.886), and the positive likelihood ratio was 4.76 and the negative likelihood ratio was 0.35, which was significantly better than the two predictions alone. Multivariate logistics regression analysis showed that TAT level>3.25 ng/mL and PIC level>1.04 μg/mL were independent risk factors for MT after PPH. 【Conclusion】 Elevated TAT and PIC levels are independent predictors of MT in patients with PPH, and their combined predictive efficacy is better.
