Wada H, Tanigawa M, Takagi M, Suzuki H, Mori Y, Ohta T, Kobayashi T, Kita K, Tanaka I, Yamaguchi T
Rinsho Ketsueki. 1989 Oct;30(10):1755-62.
We performed a blood coagulation study during the course of disseminated intravascular coagulation (DIC) in 34 patients with hematological malignancies. Risk factors of DIC such as increasing tumor mass, anti-tumor therapy and severe infections were frequently observed at onset of DIC, and influenced the prognosis of DIC. Before the onset of DIC, the DIC score and FDP value were slightly elevated, and they were significantly increased after the onset of DIC. Before the onset of DIC, the level of fibrinogen was significantly increased but it was decreased after the onset of DIC. These hemostatic abnormalities continued for about 2 weeks. Patients with DIC showing prolonged APTT and PT had a poor prognosis. The abnormalities of PT, FDP, fibrinogen, DIC score, FDP-D-dimer and fibrinopeptide A were significantly greater in DIC than in Pre-DIC defined as the period one week before the onset of DIC. FDP-D-dimer was also higher in Pre-DIC patients than in those without DIC. Although protein S and C 4 b binding protein were not decreased in DIC or Pre-DIC, Protein C activity decreased during the course of DIC, suggesting that FDP-D-dimer and Protein C activity were useful for diagnosis of Pre-DIC and DIC.
我们对34例血液系统恶性肿瘤患者在弥散性血管内凝血（DIC）病程中进行了凝血研究。DIC的危险因素，如肿瘤肿块增大、抗肿瘤治疗和严重感染，在DIC发病时经常出现，并影响DIC的预后。在DIC发病前，DIC评分和FDP值略有升高，而在DIC发病后显著增加。在DIC发病前，纤维蛋白原水平显著升高，但在DIC发病后降低。这些止血异常持续约2周。APTT和PT延长的DIC患者预后较差。DIC时PT、FDP、纤维蛋白原、DIC评分、FDP-D-二聚体和纤维肽A的异常明显大于DIC前（定义为DIC发病前一周）。DIC前患者的FDP-D-二聚体也高于无DIC患者。虽然DIC或DIC前蛋白S和C4b结合蛋白没有降低，但蛋白C活性在DIC病程中降低，提示FDP-D-二聚体和蛋白C活性对DIC前和DIC的诊断有用。
