Study on the Predictive Value of MASP-1 Combined with Four Thrombotic Molecular Markers for Disseminated Intravascular Coagulation in Patients with Severe Infection

Pengfei Chang,1,* Mengxiong Sun,2,* Huitao Song,3 Shuai Yang,2 Ze Wang,1 Lishaui Chen,1 Xunbo Wang4 1Department of Blood Transfusion, Zhangjiakou First Hospital, Zhangjiakou, Hebei Province, 075000, People’s Republic of China; 2Laboratory Department, The First Hospital of Zhangjiakou City, Zhangjiakou, Hebei Province, 075000, People’s Republic of China; 3Department of Neurology and Internal Medicine I, Zhangjiakou First Hospital, Zhangjiakou, Hebei Province, 075000, People’s Republic of China; 4Department of Respiratory Intensive Care Medicine, The First Hospital of Zhangjiakou City, Zhangjiakou, Hebei Province, 075000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xunbo Wang, Email [email protected]: To investigate the predictive value of mannose-binding lectin-associated serine protease-1 (MASP-1) combined with four thrombotic molecular markers [thrombin-antithrombin complex (TAT), thrombomodulin (TM), plasmin-α 2-plasmin inhibitor complex (PIC), and tissue-type plasminogen activator inhibitor complex (t-PAIC)] for disseminated intravascular coagulation (DIC) in patients with severe infection.Methods: Clinical data of 114 patients with severe infection admitted between January and December 2024 were retrospectively analyzed. Patients were divided into DIC (n=25) and non-DIC (n=89) groups per ISTH criteria. Serum MASP-1 (ELISA) and TAT, TM, PIC, t-PAIC (chemiluminescent immunoassay) levels were compared. Pearson correlation assessed relationships between MASP-1 and thrombotic markers. ROC curves evaluated diagnostic performance.Results: The expression levels of MASP-1, TAT, TM, PIC, and t-PAIC in Group A (with DIC) were significantly higher than those in Group B (without DIC) (P< 0.05). Pearson correlation analysis showed that MASP-1 levels in patients with severe infection and DIC were positively correlated with TAT, TM, PIC, and t-PAIC levels (P< 0.05). ROC curves showed that the area under the curve (AUC) for MASP-1, TAT, TM, PIC, t-PAIC, combined detection of thrombotic molecular markers, and MASP-1 combined with thrombotic molecular markers were 0.714, 0.739, 0.692, 0.684, 0.776, and 0.835, respectively. The diagnostic efficacy of MASP-1 combined with thrombotic molecular markers was superior to MASP-1, TAT, TM, PIC, t-PAIC alone or thrombotic molecular markers combined alone (Z MASP-1+thrombotic markers combined-MASP-1, TAT, TM, PIC, t-PAIC and thrombotic markers combined = 3.637, 3.152, 4.126, 3.974, 4.383, and 2.975, P< 0.05).Conclusion: This retrospective study suggests that MASP-1 correlates with thrombotic marker expression in severe infection. The combination of MASP-1 and thrombotic markers shows promise for improving early DIC diagnosis, but its clinical utility warrants confirmation by larger, prospective studies.Keywords: MASP-1, thrombotic molecular markers, severe infection, disseminated intravascular coagulation, predictive value