Prospective evaluation of hemostatic abnormalities in overt DIC due to various underlying diseases

被引:31
作者
Kawasugi, Kazuo [2 ]
Wada, Hideo [1 ]
Hatada, Tsuyoshi [3 ]
Okamoto, Kohji [4 ]
Uchiyama, Toshimasa [5 ]
Kushimoto, Shigeki [6 ]
Seki, Yoshinobu [7 ]
Okamura, Takashi [8 ]
Nobori, Tsutomu [1 ]
机构
[1] Mie Univ, Sch Med, Dept Mol & Lab Med, Tsu, Mie 5148507, Japan
[2] Teikyo Univ, Sch Med, Dept Internal Med, Tokyo, Tokyo, Japan
[3] Mie Univ Hosp, Emergency Crit Care Ctr, Tsu, Mie, Japan
[4] Univ Occupat & Environm Hlth, Sch Med, Dept Surg 1, Kitakyushu, Fukuoka 807, Japan
[5] Natl Hosp Org Takasaki Gen Med Ctr, Dept Internal Med, Takasaki, Gunma, Japan
[6] Nippon Med Sch, Dept Emergency & Crit Care Med, Tokyo 113, Japan
[7] Niigata Prefectural Hosp, Shibata Hosp, Dept Internal Med, Shibata, Niigata, Japan
[8] Kurume Univ, Sch Med, Div Hematol & Oncol, Dept Med, Kurume, Fukuoka 830, Japan
关键词
DIC; Underlying disease; Mortality; Global coagulation test; Hemostatic molecular marker; DISSEMINATED INTRAVASCULAR COAGULATION; HUMAN SOLUBLE THROMBOMODULIN; DIAGNOSTIC-CRITERIA; MOLECULAR MARKERS; SEVERE SEPSIS; ANTITHROMBIN; PROTEIN; NEUTROPHIL; THROMBOSIS; EFFICACY;
D O I
10.1016/j.thromres.2011.02.015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients with suspected disseminated intravascular coagulation (DIC) were prospectively evaluated for various types of underlying diseases, and the usefulness of hemostatic markers were examined for each patient with DIC due to various underlying diseases. The main underlying disease of DIC was infectious diseases, hematologic malignancies, and solid tumors, and a high resolution rate from DIC was observed in obstetric diseases and hematologic malignancies. The diagnosis of DIC was related to a poor outcome in trauma/burn victims and those with infectious disease. In the main underlying disease, it is suggested that DIC would be excluded in patients with hematologic malignancies or solid tumors with a platelet count of more than 100,000/mu l and in the patients with an FDP of less than 10 mu g/ml, and fibrinogen of less than 100 mg/dl, suggesting the presence of DIC. The prothrombin time was a sensitive marker, but fibrinogen levels were not sensitive for DIC due to infectious diseases. The plasmin plasmin inhibitor complex in hematologic malignancy, and soluble fibrin monomer complex, antithrombin and thrombomodulin in patients with infectious disease, were sensitive markers for the diagnosis of DIC. Although hemostatic markers were useful for the diagnosis of DIC, the usefulness varied depending on the different underlying diseases. (C) 2011 Elsevier Ltd. All rights reserved.
引用
收藏
页码:186 / 190
页数:5
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