Asakura Hidesaku
Department of Internal Medicine (III), Kanazawa University School of Medicine.
Rinsho Ketsueki. 2016 Apr;57(4):397-404. doi: 10.11406/rinketsu.57.397.
Disseminated intravascular coagulation (DIC) is a pathological state in which varying degrees of fibrinolytic activation are seen simultaneously as systemic, persistent, and marked coagulation activation in the presence of an underlying disease. Suppressed-fibrinolytic-type DIC usually develops in patients with sepsis. Coagulation activation is severe, while fibrinolytic activation is mild. Enhanced-fibrinolytic-type DIC usually occurs with acute promyelocytic leukemia (APL). Both coagulation activation and fibrinolytic activation are severe in affected patients. Balanced-fibrinolytic-type DIC is usually seen in patients with solid tumors, and has a pathogenesis intermediate between those of the two aforementioned types. In animal DIC models, lipopolysaccharide (LPS)-induced forms of DIC are similar to suppressed-fibrinolytic-type DIC, whereas models of tissue factor (TF)-induced DIC have features similar to those of enhanced-fibrinolytic/balanced-fibrinolytic DIC. We are moving in the direction of more appropriate selection of treatment based on DIC type.
弥散性血管内凝血（DIC）是一种病理状态，在存在基础疾病的情况下，作为全身性、持续性和显著的凝血激活，同时可见不同程度的纤溶激活。抑制纤溶型DIC通常发生在脓毒症患者中。凝血激活严重，而纤溶激活轻微。增强纤溶型DIC通常与急性早幼粒细胞白血病（APL）相关。在受影响的患者中，凝血激活和纤溶激活都很严重。平衡纤溶型DIC通常见于实体瘤患者，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DIC形式类似于抑制纤溶型DIC，而组织因子（TF）诱导的DIC模型具有与增强纤溶/平衡纤溶DIC相似的特征。我们正朝着根据DIC类型更合理选择治疗方法的方向发展。
