Levi Marcel
Department of Vascular Medicine and Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
Crit Care Med. 2007 Sep;35(9):2191-5. doi: 10.1097/01.ccm.0000281468.94108.4b.
To review the current knowledge on the clinical manifestation, pathogenesis, diagnosis, and management of disseminated intravascular coagulation (DIC).
Selected articles from the MEDLINE database.
DIC may complicate a variety of disorders and can cause significant morbidity (in particular related to organ dysfunction and bleeding) and may contribute to mortality. The pathogenesis of DIC is based on tissue factor-mediated initiation of systemic coagulation activation that is insufficiently contained by physiologic anticoagulant pathways and amplified by impaired endogenous fibrinolysis. The diagnosis of DIC can be made using routinely available laboratory tests and scoring algorithms. Supportive treatment of DIC may be aimed at replacement of platelets and coagulation factors, anticoagulant treatment, and restoration of anticoagulant pathways.
Insight into the pathogenesis of DIC has resulted in better strategies for clinical management, including straightforward diagnostic criteria and potentially beneficial supportive treatment options.
综述目前关于弥散性血管内凝血（DIC）的临床表现、发病机制、诊断及管理的知识。
MEDLINE数据库中筛选出的文章。
DIC可能使多种疾病复杂化，并可导致显著的发病率（特别是与器官功能障碍和出血相关），且可能导致死亡。DIC的发病机制基于组织因子介导的全身凝血激活的启动，生理抗凝途径对其抑制不足，且内源性纤维蛋白溶解受损使其放大。DIC的诊断可通过常规实验室检查和评分算法进行。DIC的支持性治疗可能旨在补充血小板和凝血因子、抗凝治疗以及恢复抗凝途径。
对DIC发病机制的深入了解已带来更好的临床管理策略，包括直接的诊断标准和潜在有益的支持性治疗选择。
