Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
Thromb Res. 2011 May;127(5):450-6. doi: 10.1016/j.thromres.2010.12.021. Epub 2011 Jan 21.
Monocyte and neutrophil activation occur during microvascular disturbance of disseminated intravascular coagulation (DIC). This study investigated the diagnostic and prognostic value of circulating neutrophil elastase (NE) and neutrophil volume distribution width (NDW) as neutrophil activation markers and circulating soluble CD163 (sCD163) and monocyte volume distribution width (MDW) as monocyte activation markers in 168 patients suspected of having DIC. The sCD163 provided significant diagnostic value. The prognostic value of sCD163 was comparable to that of D-dimer, but was dependent on other coagulation markers. In vitro, thrombin significantly induced sCD163 from monocytes upregulated with IL-10 or dexamethasone. NDW was an independent and powerful prognostic marker. MDW and NE did not provide diagnostic and prognostic power. Excessive thrombin during ongoing DIC induces florid secretion of CD163; sCD163 might therefore be a potential diagnostic and prognostic marker for DIC. NDW, a convenient parameter measured by an automated hematology analyzer, may be an independent prognostic parameter for DIC.
在弥散性血管内凝血 (DIC) 的微血管紊乱期间，单核细胞和中性粒细胞发生激活。本研究调查了循环中性粒细胞弹性蛋白酶 (NE) 和中性粒细胞体积分布宽度 (NDW) 作为中性粒细胞激活标志物、循环可溶性 CD163 (sCD163) 和单核细胞体积分布宽度 (MDW) 作为单核细胞激活标志物在 168 例疑似 DIC 患者中的诊断和预后价值。sCD163 提供了显著的诊断价值。sCD163 的预后价值可与 D-二聚体相媲美，但取决于其他凝血标志物。在体外，凝血酶显著诱导了用白细胞介素-10 或地塞米松上调的单核细胞中的 sCD163 分泌。NDW 是一个独立且强大的预后标志物。MDW 和 NE 没有提供诊断和预后能力。在持续发生的 DIC 期间，过多的凝血酶诱导 CD163 的大量分泌；因此，sCD163 可能是 DIC 的潜在诊断和预后标志物。NDW 是一种通过自动化血液学分析仪测量的便捷参数，可能是 DIC 的独立预后参数。
