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[一种用于肝硬化患者弥散性血管内凝血实验室诊断的建议方法]

[A proposed method for the laboratory diagnosis of disseminated intravascular coagulation in liver cirrhosis].

作者信息

Cristani A, Cioni G, Mussini C, Pentore R, Zagni G, Ventura E

机构信息

Clinica medica generale e Terapia medica III, Università, Modena.

出版信息

Recenti Prog Med. 1990 May;81(5):322-4.

PMID:2377810
Abstract

Laboratory diagnosis of disseminated intravascular coagulation (DIC) in liver cirrhosis (LC) could be complicated by the presence of the usual decrement of the hemocoagulative parameters and of an increase of the fibrinogen/fibrin degradation products (FDP). The D-dimer test, more sensible than the one for FDP and specific for the cross-linked fibrin degradation products is now available. A significant difference between the two tests, assayed simultaneously has been demonstrated in 217 LC patients, without any recent or present hemorrhagic signs. The D-dimer was increased in only 60 of the 108 patients with high values of FDP; therefore this test has a screening value higher than FDP. If only the D-dimer is elevated, the FDP assay is indicated: if FDP are normal a thrombosis may be present and, finally, if the FDP are also increased with a concomitant decrement of fibrinogenemia, the laboratory diagnosis of DIC is reasonably certain.

摘要

肝硬化(LC)患者弥散性血管内凝血(DIC)的实验室诊断可能会因血液凝固参数通常下降以及纤维蛋白原/纤维蛋白降解产物(FDP)增加而变得复杂。D - 二聚体检测比FDP检测更灵敏,且对交联纤维蛋白降解产物具有特异性,目前已有该检测方法。在217例无近期或当前出血迹象的LC患者中,同时进行这两种检测,结果显示二者存在显著差异。在108例FDP值高的患者中,仅60例D - 二聚体升高;因此,该检测的筛查价值高于FDP。若仅D - 二聚体升高,则需进行FDP检测:若FDP正常,可能存在血栓形成,最后,若FDP也升高且同时伴有纤维蛋白原血症下降,则DIC的实验室诊断基本可以确定。

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