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Objective To study the warning indicators and clinical value of coagulopathy related to traumatic lung injury(TLI). Methods The data of 159 patients with TLI from September 2015 to November 2019 in the intensive care unit of the 908th Hospital of Chinese PLA Logistical Support Force were analyzed retrospectively, including their hemoglobin (HGB), platelet (PLT), fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), thrombin time (TT), D-dimer (D-D), antithrombin Ⅲ (AT-Ⅲ), fibrin degradation product (FDP) and thromboelastography.According to the 90-d prognosis of patients with TLI, they were divided into survival group (n=141) and death group (n=18). COX regression analysis and ROC curve analysis were carried out, and the risk factors INR were screened out. The patients were divided into INR≥1.36 group (n=49) and INR<1.36 group (n=110) for analysis. Results In survival group, INR, lactate (Lac), and injury severe score (ISS) score were significantly lower than those in death group (Z=–4.493, –3.481, –3.177, P<0.01); APTT, PT, R time and K time were much shorter than death group (Z=–3.275, –4.325, –3.300, –2.278, P<0.01); Oxygenation index, PLT, HGB, AT-Ⅲ, blood clots maximum intensity (MA), blood clot formation dynamics (Angle) and coagulation index (CI) were significantly better than those in death group (Z/t=–4.053, –2.764, 0.269, –2.159, –3.058, –3.294, –3.016, P<0.01). Cox regression analysis showed that INR (RR=2.18, 95%CI 1.07-4.43, P=0.031) were significantly correlated with the death of TLI patients. ROC curve analysis showed that the area under the curve for INR to judge the death of TLI patients was 0.826 (P<0.0001), the cut-off value was 1.36 (P<0.0001)and the sensitivity and specificity were 0.788 and 0.752, respectively. The survival rate in INR<1.36 group was significantly higher than that in INR≥1.36 group (P<0.0001). Compared with INR<1.36 group, in INR≥1.36 group, the Lac and ISS score significantly increased (P<0.05); APTT, PT and K time significantly prolonged (P<0.05); the oxygenation index, PLT, HGB, AT-Ⅲ, MA, Angle and CI decreased significantly (P<0.05). Conclusions TLI patients with INR≥1.36 can be used as an early warning indicator of TLI-related coagulopathy, and the risk of death of TLI related coagulation disease patients is significantly increased.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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