Department of Internal Medicine (III), Kanazawa University School of Medicine, Takaramachi 13-1, Kanazawa, Ishikawa, 920-8641 Japan.
J Intensive Care. 2014 Mar 6;2(1):20. doi: 10.1186/2052-0492-2-20. eCollection 2014.
Disseminated intravascular coagulation (DIC) has a common pathogenesis in terms of persistent widespread activation of coagulation in the presence of underlying disease, but the degree of fibrinolytic activation often differs by DIC type. DIC with suppressed fibrinolysis is a DIC type usually seen in sepsis. Coagulation activation is severe, but fibrinolytic activation is mild. DIC with enhanced fibrinolysis is a DIC type usually seen in acute promyelocytic leukemia (APL). Both coagulation activation and fibrinolytic activation are severe. DIC with balanced fibrinolysis is a DIC type usually seen in solid tumors, with an intermediate pathogenesis between the above two types. In animal DIC models, lipopolysaccharide (LPS)-induced models are similar to suppressed-fibrinolytic-type DIC, whereas tissue factor (TF)-induced models are similar to enhanced fibrinolytic/balanced fibrinolytic DIC. Appropriate diagnosis and treatment may also differ depending on the DIC type.
弥散性血管内凝血（DIC）在存在基础疾病的情况下，凝血持续广泛激活方面具有共同的发病机制，但纤溶激活的程度通常因 DIC 类型而异。伴有抑制性纤溶的 DIC 是一种通常见于脓毒症的 DIC 类型。凝血激活严重，但纤溶激活较轻。伴有增强纤溶的 DIC 是一种通常见于急性早幼粒细胞白血病（APL）的 DIC 类型。凝血激活和纤溶激活都很严重。伴有平衡纤溶的 DIC 是一种通常见于实体瘤的 DIC 类型，其发病机制介于上述两种类型之间。在动物 DIC 模型中，脂多糖（LPS）诱导的模型类似于抑制性纤溶型 DIC，而组织因子（TF）诱导的模型类似于增强性/平衡性纤溶 DIC。适当的诊断和治疗也可能因 DIC 类型而异。
