Nakagawa T, Saito H, Watanabe Y, Sato M, Murakawa E
Department of Laboratory Medicine, Niigata Cancer Center Hospital.
Rinsho Byori. 1991 Mar;39(3):309-14.
Eighty six plasma samples from 41 patients with suspected disseminated intravascular coagulation (DIC) were divided into 3 groups as follows: Group A, 53 samples from established DIC; Group B, 19 samples from possible DIC; and Group C, 14 samples from probable DIC. The following parameters of coagulation and fibrinolysis were evaluated: thrombin/antithrombin III complex (TAT), plasmin/alpha 2 plasmin inhibitor complex (PIC), D-dimer (D-D) and fibrin monomer (FM). In Group A, TAT and PIC were significantly elevated, being 29.5 +/- 20.7 micrograms/l and 7.2 +/- 6.1 mg/l respectively, suggesting marked hypercoagulability and accelerated fibrinolysis. There were no correlations between antithrombin III (ATIII) and TAT, between alpha 2 plasmin inhibitor (alpha 2PI) and PIC, or between TAT and PIC, showing the clinical diversity of patients with DIC. In all groups abnormal TAT, PIC and D-D findings were observed in many samples (86-100%), and FM was present in 83%, 63%, and 29% of samples in Groups A, B, and C respectively. In Groups B and C, abnormal findings for TAT, PIC, D-D, FM and alpha 2PI apparently indicated hypercoagulability and accelerated fibrinolysis, even though fibrinogen and platelet count were within normal limits.
从41例疑似弥散性血管内凝血（DIC）患者中采集的86份血浆样本被分为以下3组：A组，来自确诊DIC患者的53份样本；B组，来自可能患有DIC患者的19份样本；C组，来自很可能患有DIC患者的14份样本。对以下凝血和纤溶参数进行了评估：凝血酶/抗凝血酶III复合物（TAT）、纤溶酶/α2纤溶酶抑制物复合物（PIC）、D-二聚体（D-D）和纤维蛋白单体（FM）。在A组中，TAT和PIC显著升高，分别为29.5±20.7微克/升和7.2±6.1毫克/升，提示明显的高凝状态和纤溶加速。抗凝血酶III（ATIII）与TAT之间、α2纤溶酶抑制物（α2PI）与PIC之间或TAT与PIC之间均无相关性，这显示了DIC患者的临床多样性。在所有组中，许多样本（86%-100%）均观察到TAT、PIC和D-D异常，A、B、C组中分别有83%、63%和29%的样本存在FM。在B组和C组中，TAT、PIC、D-D、FM和α2PI的异常结果显然提示高凝状态和纤溶加速，尽管纤维蛋白原和血小板计数在正常范围内。
