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重症监护病房中弥散性血管内凝血患者的止血标志物与脓毒症相关器官功能衰竭评估评分

Hemostatic markers and the sepsis-related organ failure assessment score in patients with disseminated intravascular coagulation in an intensive care unit.

作者信息

Okabayashi Kazuhiro, Wada Hideo, Ohta Syunsuke, Shiku Hirosi, Nobori Tsutomu, Maruyama Kazuo

机构信息

Department of Anesthesiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.

出版信息

Am J Hematol. 2004 Jul;76(3):225-9. doi: 10.1002/ajh.20089.

Abstract

We investigated the correlation between disseminated intravascular coagulation (DIC) score and hemostatic parameters and sepsis-related organ failure assessment (SOFA) score with clinical outcome of patients with DIC in an intensive care unit (ICU). The SOFA score was markedly elevated in patients with DIC relative to patients without DIC and significantly higher in non-survivors than in survivors. Abnormalities in almost all hemostatic parameters were significant in patients with DIC, but there was no significant difference in almost all hemostatic parameters between survivors and non-survivors. However, plasma antithrombin (AT) levels were significantly lower in non-survivors than in survivors. Soluble fibrin (SF) and tissue type plasminogen activator (tPA)-plasminogen activator inhibitor-I (PAI-I) complex correlated significantly with the SOFA score, whereas AT levels correlated significantly and negatively with the SOFA score. We conclude that the SOFA score is useful for predicting outcome in DIC patients in the ICU, and that hemostatic parameters, especially plasma AT levels, are also useful markers for organ failure and clinical outcome.

摘要

我们在重症监护病房(ICU)中研究了弥散性血管内凝血(DIC)评分与止血参数以及脓毒症相关器官功能衰竭评估(SOFA)评分与DIC患者临床结局之间的相关性。与无DIC的患者相比,DIC患者的SOFA评分显著升高,且非幸存者的SOFA评分显著高于幸存者。几乎所有止血参数的异常在DIC患者中均有显著性,但幸存者与非幸存者之间几乎所有止血参数均无显著差异。然而,非幸存者的血浆抗凝血酶(AT)水平显著低于幸存者。可溶性纤维蛋白(SF)和组织型纤溶酶原激活物(tPA)-纤溶酶原激活物抑制剂-I(PAI-I)复合物与SOFA评分显著相关,而AT水平与SOFA评分显著负相关。我们得出结论,SOFA评分有助于预测ICU中DIC患者的结局,止血参数尤其是血浆AT水平也是器官功能衰竭和临床结局的有用标志物。

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