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[重组血栓调节蛋白治疗尿路感染所致弥散性血管内凝血;与对照病例的回顾性比较研究]

[Treatment with recombinant thrombomodulin on disseminated intravascular coagulation caused by urinary tract infections; a retrospective comparative study with control cases].

作者信息

Machioka Kazuaki, Shigehara Kazuyoshi, Kadomoto Suguru, Iwamoto Hiroaki, Miyagi Tohru, Nakashima Takao, Namiki Mikio

机构信息

The Department of Urology, Ishikawa Prefectural Central Hospital; The Department of Integrative Therapy and Urology, Kanazawa University Graduate School of Medical Science.

The Department of Urology, Ishikawa Prefectural Central Hospital.

出版信息

Hinyokika Kiyo. 2015 Jan;61(1):1-6.

Abstract

We examined the efficacy of recombinant thrombomodulin (rTM) for treatment of patients with disseminated intravascular coagulation (DIC) caused by urinary tract infections. Thirteen DIC patients treated with rTM (rTM group) and 11 not receiving rTM (non-rTM group) were enrolled in this study. Blood data including coagulation markers collected before and after the treatment,a hospitalized term,and period of antibiotic treatment were compared. There were no significant differences in baseline characteristics between the two groups. Both groups showed significant improvement in all parameters such as blood biochemical data,coagulation markers,and DIC score 5-7 days after treatment. However, changes in platelet and DIC score from baseline to early phase (day 1-3) were significantly greater in the rTM group than in the non-rTM group (p<0.05). In addition,changes in FDP value showed slight but not significant improvement in rTM group compared to the non-rTM group in the early treatment phase (p= 0.084). The period of antibiotic usage was significantly shorter in the rTM group,whereas the hospitalized term showed no significant difference between the groups. Definite adverse effects were not present in the rTM group. In conclusion,administration of rTM may have a beneficial effect in patients with DIC induced by urinary tract infections,compared with conventional treatment.

摘要

我们研究了重组血栓调节蛋白(rTM)对治疗由尿路感染引起的弥散性血管内凝血(DIC)患者的疗效。本研究纳入了13例接受rTM治疗的DIC患者(rTM组)和11例未接受rTM治疗的患者(非rTM组)。比较了治疗前后收集的包括凝血指标在内的血液数据、住院时间和抗生素治疗时间。两组患者的基线特征无显著差异。两组患者在治疗后5 - 7天,血液生化数据、凝血指标和DIC评分等所有参数均有显著改善。然而,rTM组血小板和DIC评分从基线到早期阶段(第1 - 3天)的变化明显大于非rTM组(p<0.05)。此外,在早期治疗阶段,rTM组FDP值的变化与非rTM组相比虽有轻微改善但无显著差异(p = 0.084)。rTM组抗生素使用时间明显较短,而两组住院时间无显著差异。rTM组未出现明确的不良反应。总之,与传统治疗相比,给予rTM可能对尿路感染诱发的DIC患者有益。

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