Schmidt B K, Muraji T, Zipursky A
Eur J Pediatr. 1986 Dec;145(6):500-3. doi: 10.1007/BF02429051.
Low antithrombin III (AT III) levels in shock are usually ascribed to disseminated intravascular coagulation (DIC). However, decreased activities of clotting factors and their inhibitors could reflect a generalised fall in plasma proteins rather than DIC. AT III and albumin were compared in 48 asphyxiated and non-asphyxiated newborn rabbits (pH 6.70-7.30). Both AT III and albumin were markedly decreased in the sickest animals and there was a direct linear relationship between the two proteins (P less than 0.001). Similar results were obtained in ten newborn infants suffering from shock and haemorrhagic diathesis. In all cases AT III and albumin were decreased below the normal range and significantly correlated (P less than 0.01). Our findings suggest that AT III is not a useful diagnostic marker of DIC. Further, a similar fall of clottable and non-clottable proteins in shock questions the general assumption that the ensuing coagulopathy is due to intravascular coagulation.
休克时抗凝血酶III（AT III）水平降低通常归因于弥散性血管内凝血（DIC）。然而，凝血因子及其抑制剂活性降低可能反映血浆蛋白普遍减少，而非DIC。对48只窒息和未窒息新生兔（pH 6.70 - 7.30）的AT III和白蛋白进行了比较。病情最严重的动物中，AT III和白蛋白均显著降低，且两种蛋白之间存在直接线性关系（P < 0.001）。在10例患有休克和出血素质的新生儿中也得到了类似结果。所有病例中，AT III和白蛋白均降至正常范围以下，且显著相关（P < 0.01）。我们的研究结果表明，AT III并非DIC的有用诊断标志物。此外，休克时可凝固和不可凝固蛋白类似程度的降低，对随之而来的凝血病是由于血管内凝血这一普遍假设提出了质疑。
