血小板活化标志物及其在脓毒症相关性弥散性血管内凝血患者中的预后价值。
Biomarkers of Platelet Activation and Their Prognostic Value in Patients With Sepsis-Associated Disseminated Intravascular Coagulopathy.
机构信息
Department of Pathology, Loyola University Medical Center, Maywood, IL, USA.
Department of Pharmacology, Loyola University Medical Center, Maywood, IL, USA.
出版信息
Clin Appl Thromb Hemost. 2021 Jan-Dec;27:1076029620943300. doi: 10.1177/1076029620943300.
Sepsis-associated disseminated intravascular coagulation (DIC) is related to marked hemostatic changes such as transient thrombocytopenia secondary to the endogenous activation and consumption of platelets. This study measured markers of platelet function in 103 adult ICU patients with clinically established sepsis-associated DIC to determine the biomarker association with disease severity. Patients were categorized as having no DIC, nonovert DIC, or overt DIC using the International Society of Thrombosis and Hemostasis scoring system. Plasma levels of CD40L, platelet factor 4 (PF4), platelet-derived microparticles, and microparticle-associated tissue factor were quantified. Markers of platelet activation were significantly elevated in patients with DIC compared to healthy individuals. This increase was independent of platelet count. Levels of PF4 differed based on the severity of DIC and differentiated nonsurvivors and survivors. These findings suggest that the markers of platelet activation in DIC may not be regulated by the number of circulating platelets and may be independent of the factors leading to their consumption.
脓毒症相关性弥散性血管内凝血(DIC)与明显的止血变化有关,例如继发于血小板内源性激活和消耗的短暂性血小板减少症。本研究在 103 名成人 ICU 脓毒症相关性 DIC 患者中测量了血小板功能标志物,以确定与疾病严重程度相关的生物标志物。患者使用国际血栓与止血学会评分系统分为无 DIC、非显性 DIC 和显性 DIC。定量检测 CD40L、血小板因子 4(PF4)、血小板衍生微粒和微粒相关组织因子的血浆水平。与健康个体相比,DIC 患者的血小板激活标志物显著升高。这种增加与血小板计数无关。PF4 水平根据 DIC 的严重程度而有所不同,并区分了非幸存者和幸存者。这些发现表明,DIC 中血小板激活标志物的调节可能不受循环血小板数量的影响,并且可能独立于导致其消耗的因素。