Prognostic value of tissue plasminogen activator-inhibitor complexes in patients with sepsis associated thrombocytopenia
10.13602/j.cnki.jcls.2025.11.05
- VernacularTitle:组织型纤溶酶原激活物-抑制剂复合物对脓毒症合并血小板减少患者预后的预测价值
- Author:
Fang WANG
1
;
Hao LIAO
1
;
Tian XU
1
;
Jingchun SONG
1
Author Information
1. 中国人民解放军联勤保障部队第九○八医院重症医学科,南昌 330002
- Publication Type:Journal Article
- Keywords:
sepsis;
thrombocytopenia;
random forest;
Lasso regression;
tissue plasminogen activator-inhibitor complex(tPAIC)
- From:
Chinese Journal of Clinical Laboratory Science
2025;43(11):824-829
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the prognostic value of tissue plasminogen activator-inhibitor complex(tPAIC)for mortality in patients with sepsis associated thrombocytopenia(SAT).Methods A retrospective analysis was conducted on the clinical data of 74 patients with SAT admitted to the Intensive Care Unit of the 908th Hospital of the Joint Logistics Support Force of PLA between Septem-ber 2017 and December 2021.Based on 28-day follow-up for outcomes,the patients were divided into survival group(43 cases)and death group(31 cases).The Boruta algorithm based on random forest and Lasso regression algorithm were used to screen the risk fac-tors from a total of 29 candidate variables,including age,sex,SOFA score on admission,APACHE Ⅱ score,and various hematological indexes,(e.g.,white blood cell count).The time-dependent receiver operating characteristic(ROC)curves and the survival analysis were performed for the key variables identified.Results Compared with the survival group,the nonsurvivors in death group had signif-icantly higher SOFA and APACHE Ⅱ scores.The levels of thrombomodulin(TM),thrombin-antithrombin complex(TAT),and tissue plasminogen activator inhibitor complex(tPAIC)were also markedly elevated in death group(P＜0.05).Similarly,PT,APTT,TT,FDP,and D-dimer in the death group were significantly higher than those in survivalroup,whereas the fibrinogen levels were signifi-cantly decreased(P＜0.05).The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(T-Bil),and lactate(Lac)levels were likewise significantly elevated in the death group.Random forest and Lasso regression analysis identified SOFA score,tPAIC,INR,and Lac as the independent risk factors of mortality in the patients with sepsis-associated thrombo-cytopenia(SAT)patients.Time-dependent ROC curve analysis showed that a higher C-index and average area under the curve(AUC)in tPAIC than any other variables for predicting the prognosis of SAT patients.Kaplan-Meier survival analysis stratified by the optimal cutoff value of tPAIC(38.9 ng/mL)revealed that a 2.31-fold higher 28-day survival rate in the patients with tPAIC＜38.9 ng/mL group compared those with tPAIC ≥38.9 ng/mL.Conclusion tPAIC demonstrates significant predictive value for mortality in SAT patients.
