Variations And Significance Of Blood Coagulation Biomarkers In Disseminated Intravascular Coagulation

Objectives To explore the plasma levels of thrombin-anti-thrombin complex(TAT),plasmin-a2-plasmin inhibitor complex(PIC),thrombomodulin(TM).tissue-type plasminogen activator-plasminogen activator inhibitor complex(t-PAl-C)in patients with disseminated intravascular coagulation(DIC)and evaluate the significance of them in early diagnosis of DIC.Materials and Methods We enrolled all the 33 patients with coagulopathy in Qilu Hospital of Shandong University from September 2016 to March 2017.On admission 9 cases were diagnosed with DIC,24 cases were diagnosed with suspected DIC.5 cases of the suspected DIC developed into DIC later.Finally,we divided them into DIC group(14 cases)and non-DIC group(19 cases).Plasma levels of TAT,PIC,TM,t-PAI-C were all measured with high sensitivity chemiluminescence in DIC group and non-DIC group at the moment of admission and on the day 3,7.Plasma concentrations of TAT,PIC,TM,t-PAI-C were measured in the control group of 30 people,excluded by blood system diseases,infection,trauma,thrombosis,liver and kidney diseases.Results Day 1 and day 3 serum concentrations of TAT were higher in patients with DIC(16.83± 13.21,21.66±24.58)ng/mL than those with non-DIC(4.9±2.62.3.47± 1.69)ng/mL and P=0.005,0.016,respectively.Day 1 serum concentrations of PIC were higher in patients with DIC(4.63 ±6.23)?g/mL than those with non-DIC(0.93±0.59)?g/mL and P=0.045.Day 1.day 3 and day 7 serum concentrations of TM were higher in patients with DIC(31.31± 18.75,36.61 ±20.31,30.21 ±18.32)TU/mL than those with non-DIC(11.19±2.99,11.1 ±4.32,11.37±3.88)TU/mL and P=0.001,<0.001,0.002,respectively.Day 7 serum concentrations of t-PAI-C were higher in patients with DIC(24.23 ±29.9)ng/mL than those with non-DIC(6.72 ±4.56)ng/mL and P=0.048.The group of patients with DIC had higher TAT(18.10±21.23)ng/mL,PIC(3.80±5.02)?g/mL,TM(32.71± 18.88)TU/mL,t-PAI-C(23.93±32.30)ng/mL than group with non-DIC TAT(4.37±4.40)ng/mL,PIC(1.03±0.69)?g/mL,TM(11.22±3.71)TU/mL,t-PAI-C(6.87±4.35)ng/mL and P<0.001,0.001,0.001,<0.001,respectively.They were all statistically significant.The area under the receiver operating characteristic curve of day 1 serum TAT and TM levels was 0.83,0.91 respectively,and P<0.01.Conclusions Plasma levels of TAT.PIC,TM were significantly increased in early DIC.The dynamic detection of plasma levels of TAT,PIC and TM is useful for early diagnosis of DIC.