Mori P G, Boeri E, Molinari A C, Odino S, Favareto F, Pecorara M, Arigliani R
IV Divisione Pediatrica, Istituto Giannina Gaslini, Genova, Italia.
Pediatr Med Chir. 1987 Jul-Aug;9(4):469-72.
The laboratory tests of 38 patients in pediatric age with Disseminated Intravascular Coagulation (DIC) were retrospectively evaluated. In all patients were performed PT, aPTT, platelets count, FDP dosage and biological assay of Fibrinogen. In most of them the activity of FII, FV, FVII, FX and FVIII was assaied. According to the diagnostic criteria of FSP greater than 8 micrograms/ml, Platelets less than 150 10(9)/1 and Fibrinogen less than 150 ml/dl, in 16 patients the diagnosis of DIC was possible since first examination, while in 9 patients it became possible within 2-4 days; in 13 patients we never could diagnose DIC, although it was reasonably present, since the criteria above mentioned were never simultaneously satisfied. Looking back in our experience, we confirm that the platelets count and the quantitation of plasmatic Fibrin Degradation Products (FDP) are the most useful tests for the diagnosis of full blown DIC, and that the biological assay of plasmatic fibrinogen helps to follow the disorder. A low level of FVIII:C seems to be a forecast of failure. None of the other test performed give any useful information for diagnosis when it is not possible with the above mentioned tests.
对38例小儿弥散性血管内凝血（DIC）患者的实验室检查进行了回顾性评估。所有患者均进行了凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）、血小板计数、纤维蛋白降解产物（FDP）定量及纤维蛋白原生物学测定。大多数患者还检测了凝血因子Ⅱ、Ⅴ、Ⅶ、Ⅹ和Ⅷ的活性。根据纤维蛋白原降解产物（FSP）大于8微克/毫升、血小板小于150×10⁹/升和纤维蛋白原小于150毫克/分升的诊断标准，16例患者首次检查时即可诊断为DIC，9例患者在2 - 4天内确诊；13例患者尽管可能存在DIC，但由于上述标准从未同时满足，我们始终未能诊断。回顾我们的经验，我们证实血小板计数和血浆纤维蛋白降解产物（FDP）定量是诊断典型DIC最有用的检查，血浆纤维蛋白原生物学测定有助于跟踪病情。FVIII:C水平低似乎预示着治疗失败。当上述检查无法做出诊断时，所进行的其他检查均未提供任何有用的诊断信息。
