Asakura H
Third Department of Internal Medicine (III) Kanazawa University School of Medicine.
Rinsho Ketsueki. 1990 Jun;31(6):756-62.
Early diagnosis and immediate treatment of the disease responsible for DIC are most important for successful therapy of DIC. Furthermore, it is also necessary to use anticoagulant agents in most cases of DIC. The agents may be classified on the basis of their mode of anticoagulant action into three groups: ones with antithrombin effect, ones with anti-Xa effect or ones with both effect, and each agent is hoped to be chosen appropriately for development of DIC in near future. At present, such anticoagulant agents as standard heparin, antithrombin-III concentrate, gabexate mesilate, nafamostat mesilate, MD-805, low molecular weight heparin, heparan sulfate, activated protein C, are known as drugs for DIC, and each of them was effective for improvement from DIC in our experience. Antifibrinolytic agents, which have been considered to be contraindicated for therapy of DIC, may be good indication for selected cases of DIC with enhanced fibrinolysis such cases as acute promyelocytic leukemia. Antiplatelet agents may be available for some cases of chronic DIC.
对导致弥散性血管内凝血(DIC)的疾病进行早期诊断和立即治疗,对于DIC的成功治疗最为重要。此外,在大多数DIC病例中使用抗凝剂也是必要的。这些药物可根据其抗凝作用方式分为三类:具有抗凝血酶作用的药物、具有抗Xa作用的药物或兼具两者作用的药物,希望在不久的将来能针对DIC的发展适当选择每种药物。目前,诸如标准肝素、抗凝血酶III浓缩物、甲磺酸加贝酯、甲磺酸萘莫司他、MD - 805、低分子量肝素、硫酸乙酰肝素、活化蛋白C等抗凝剂被认为是治疗DIC的药物,根据我们的经验,它们中的每一种对改善DIC都有效。曾被认为是DIC治疗禁忌的抗纤溶药物,对于某些纤溶增强的DIC病例,如急性早幼粒细胞白血病,可能是很好的适应证。抗血小板药物可能适用于某些慢性DIC病例。