血清MCPIP1、MPV/PLT、凝血酶原时间、纤维蛋白原对五步蛇咬伤患者预后的预测价值

The predictive value of serum MCPIP1, MPV/PLT, prothrombin time, and fibrinogen levels for the prognosis of Deinagkistrodon acutus bite patients

摘要:

目的 探究血清单核细胞趋化蛋白-1诱导蛋白1（MCPIP1）、平均血小板体积与血小板计数比值（MPV/PLT）、凝血酶原时间（PT）、纤维蛋白原（FIB）对五步蛇咬伤患者预后的预测价值。方法 选取2019年9月—2025年9月金华市中心医院救治的100例五步蛇咬伤患者作为观察组，并根据病情严重程度分为轻型（55例）、重型（31例）及危重型（14例），根据痊愈情况分为痊愈组（87例）与未痊愈组（13例），另选取该院同期50例健康体检者作为对照组。比较受试者血清MCPIP1、MPV/PLT、PT及FIB，绘制受试者工作特征（ROC）曲线分析MCPIP1、MPV/PLT、PT及FIB对五步蛇咬伤患者预后的预测价值。结果 观察组MCPIP1、MPV/PLT及PT值均高于对照组（P <0.05），FIB低于对照组（P <0.05）。轻型组、重型组及危重型组的MCPIP1、MPV/PLT、PT及FIB比较，差异均有统计学意义（P <0.05）。未痊愈组的MCPIP1、MPV/PLT和PT值均高于痊愈组（P <0.05），FIB低于痊愈组（P <0.05）。ROC曲线分析结果表明，MCPIP1、MPV/PLT、PT、FIB联合预测的曲线下面积为0.981（95% CI：0.955，1.000），敏感性为92.3%（95% CI：0.640，0.998），特异性为98.9%（95% CI：0.938，1.000）。结论 联合检测血清MCPIP1、MPV/PLT、PT及FIB对五步蛇咬伤患者预后具有良好的预测价值。

Abstract:

Objective To investigate the predictive value of serum monocyte chemoattractant protein-1-induced protein-1 (MCPIP1) levels, mean platelet volume to platelet count ratio (MPV/PLT), prothrombin time (PT), and fibrinogen (FIB) levels for the prognosis of patients bitten by Deinagkistrodon acutus (sharp-snouted pit viper).Methods A total of 100 patients with Deinagkistrodon acutus bites admitted to our hospital from September 2019 to September 2025 were selected as the observation group. According to the severity of their condition, they were classified into mild (n = 55), severe (n = 31), and critical (n = 14) groups. Based on the recovery status, they were divided into a recovered group (n = 87) and a non-recovered group (n = 13). Additionally, 50 healthy individuals undergoing physical examinations during the same period were selected as the control group. MCPIP1, MPV/PLT, PT, and FIB levels were compared among the groups. The receiver operating characteristic (ROC) curve was constructed to analyze the predictive value of these indicators for the prognosis of the patients.Results The levels of MCPIP1, MPV/PLT, and PT in the observation group were significantly higher than those in the control group, while FIB levels were significantly lower (P < 0.05). There were statistically significant differences in MCPIP1, MPV/PLT, PT, and FIB levels among patients in the mild, severe, and critical groups (P < 0.05). The levels of MCPIP1, MPV/PLT, and PT in the non-recovered group were significantly higher than those in the recovered group, while the FIB level was significantly lower (P < 0.05). ROC curve analysis showed that the combination of MCPIP1, MPV/PLT, PT, and FIB for prediction achieved an AUC of 0.981（95% CI：0.955，1.000）, with a sensitivity of 92.3% (95% CI: 0.640, 0.998) and a specificity of 98.9% (95% CI: 0.938, 1.000).Conclusion Serum levels of MCPIP1, MPV/PLT, FIB, and PT demonstrate significant predictive value for the prognosis of patients bitten by Deinagkistrodon acutus.