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日本血栓与止血学会制定的弥散性血管内凝血改良诊断标准的评估

An Evaluation of the Modified Diagnostic Criteria for DIC Established by the Japanese Society of Thrombosis and Hemostasis.

作者信息

Aota Takumi, Wada Hideo, Yamashita Yoshiki, Matsumoto Takeshi, Ohishi Kohshi, Suzuki Kei, Imai Hiroshi, Usui Masanobu, Isaji Shuji, Asakura Hidesaku, Okamoto Kohji, Katayama Naoyuki

机构信息

1 Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan.

2 Departments of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Mie, Japan.

出版信息

Clin Appl Thromb Hemost. 2017 Sep;23(6):579-584. doi: 10.1177/1076029616654263. Epub 2016 Jun 14.

Abstract

OBJECTIVE

We evaluated the modified diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH) in 108 patients with suspected infectious DIC.

MATERIAL AND METHODS

The diagnoses of the patients were as follows: DIC (n = 63), pre-DIC (n = 22), and non-DIC (n = 45). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver-operating characteristic analysis.

RESULTS

Although the area under the curve for global coagulation test (GCT) scores in the diagnosis of "DIC" was high that for the diagnosis of "DIC and pre-DIC" was low, suggesting that the addition of antithrombin (AT), soluble fibrin (SF)/thrombin-AT complex (TAT), and reduced platelet count (PLT) values was required to diagnose "DIC and pre-DIC." Using GCT score with the AT, SF/TAT, and reduced PLT values, the cutoff value of the DIC score for the diagnosis of "DIC and pre-DIC" was 5 points.

DISCUSSION AND CONCLUSION

The modified JSTH's diagnostic criteria for DIC, which used the GCT score and the reduced PLT, AT, and TAT/SF values, were useful for diagnosing "DIC and pre-DIC."

摘要

目的

我们对日本血栓与止血学会(JSTH)发布的弥散性血管内凝血(DIC)改良诊断标准在108例疑似感染性DIC患者中进行了评估。

材料与方法

患者的诊断结果如下:DIC(n = 63)、DIC前期(n = 22)和非DIC(n = 45)。采用受试者工作特征分析评估DIC诊断标准的有效性。

结果

尽管在诊断“DIC”时全局凝血试验(GCT)评分的曲线下面积较高,但在诊断“DIC和DIC前期”时该面积较低,这表明诊断“DIC和DIC前期”需要加入抗凝血酶(AT)、可溶性纤维蛋白(SF)/凝血酶-抗凝血酶复合物(TAT)以及降低的血小板计数(PLT)值。使用GCT评分结合AT、SF/TAT以及降低的PLT值时,诊断“DIC和DIC前期”的DIC评分临界值为5分。

讨论与结论

JSTH改良的DIC诊断标准,即使用GCT评分以及降低的PLT、AT和TAT/SF值来诊断“DIC和DIC前期”是有用的。

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