在大肠杆菌败血症狒狒模型中，凝血整体测试反应与中性粒细胞、内皮细胞及止血系统扰动分子标志物的比较——旨在区分失代偿显性弥散性血管内凝血和代偿性非显性弥散性血管内凝血。
Comparison of the responses of global tests of coagulation with molecular markers of neutrophil, endothelial, and hemostatic system perturbation in the baboon model of E. colisepsis--toward a distinction between uncompensated overt DIC and compensated non-overt DIC.
作者信息
Wada H, Yamamuro M, Inoue A, Shiku H, Sakuragawa N, Redl H, Peer G, Taylor F B
机构信息
Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
出版信息
Thromb Haemost. 2001 Dec;86(6):1489-94.
This study correlates changes in neutrophilic activity and endothelial injury with markers of hemostatic activity following the infusion of increasing concentrations of E. coli organisms. It focuses on the hemostatic response as a marker of microvascular injury and uses the response to increasing concentrations of E. coli to refine our definition of disseminated intravascular coagulation (DIC) and distinguish between a compensated (non-overt DIC) and uncompensated (overt DIC) response. We observed that the global coagulation tests reflected activation of the hemostatic system in a dose dependent manner (overt DIC) in the early phases (T+2 to 6 h) of the response to increasing concentrations of E. coli, but that they failed to do so in the late phases (T+ 24 to 48 h). We observed that molecular markers, soluble thrombomodulin and elastase, unlike thrombin/antithrombin and plasmin/antiplasmin complexes, remained elevated out to T+24 to 48 h indicating endothelial injury that persists beyond the initial inflammatory insult in compensated as well as uncompensated DIC.
本研究将嗜中性粒细胞活性和内皮损伤的变化与输注浓度递增的大肠杆菌后止血活性标志物进行关联。它将止血反应作为微血管损伤的一个标志物，并利用对浓度递增的大肠杆菌的反应来完善我们对弥散性血管内凝血（DIC）的定义，并区分代偿性（非显性DIC）和失代偿性（显性DIC）反应。我们观察到，在对浓度递增的大肠杆菌的反应的早期阶段（T + 2至6小时），全局凝血试验以剂量依赖性方式（显性DIC）反映了止血系统的激活，但在后期阶段（T + 24至48小时）则未能如此。我们观察到，与凝血酶/抗凝血酶和纤溶酶/抗纤溶酶复合物不同，分子标志物可溶性血栓调节蛋白和弹性蛋白酶在T + 24至48小时仍保持升高，表明在代偿性和失代偿性DIC中，内皮损伤在初始炎症损伤之后仍持续存在。
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