Bratić-Mikes V
Bilt Hematol Transfuz. 1975;3(3):49-59.
Two patients with tuberculosis complicated with disseminated intravascular coagulation are presented. The first patient had spleenic and mesenteric lymph nodes tuberculosis (accompanied by gastrointestinal symptoms (diarrhoea) lasting for several years) in which DIC was terminal fatal complication. Coagulation disorder was characterized by a decrease of fibrinogen concentration in blood, thrombocytopenia and other disorders as well as haemorrhagic syndrome. The second patient had miliary tuberculosis presented by X-ray changes on the lungs, granuloma in the liver and positive cultures in the sputum. Both laboratory and clinical signs of DIC manifested in the beginning of the disease. Heparin treatment was successful: haemorrhages stopped already 24 hours later, while an increase of fibrinogen concentration and number of platelets in blood proceeded at slower rate. As the patient had overcome the critical period, treatment of the primary disease was successful and led to complete recovery.
本文介绍了两名合并弥散性血管内凝血的肺结核患者。首例患者患有脾及肠系膜淋巴结结核(伴有持续数年的胃肠道症状(腹泻)),其中弥散性血管内凝血是终末期致命并发症。凝血障碍的特征为血液中纤维蛋白原浓度降低、血小板减少及其他紊乱,以及出血综合征。第二例患者为粟粒性肺结核,肺部X线有改变,肝脏有肉芽肿,痰培养阳性。弥散性血管内凝血的实验室及临床体征在疾病初期均有表现。肝素治疗取得成功:24小时后出血即停止,而血液中纤维蛋白原浓度及血小板数量的增加则较为缓慢。由于患者度过了危险期,原发性疾病的治疗成功,最终完全康复。