Willoughby M L, Murphy A V, McMorris S, Jewell F G
Arch Dis Child. 1972 Oct;47(255):766-71. doi: 10.1136/adc.47.255.766.
Serial coagulation investigations were performed in 4 children with the haemolytic uraemic syndrome treated with heparin by continuous infusion. 2 anuric patients showed consumption of factor V and fibrinogen early in the disease, with thrombocytopenia and raised fibrin degradation products. These changes regressed during heparin therapy and renal function fully recovered in both patients. A third patient with a mild form of the disease, normal urinary output, and only borderline thrombocytopenia did not develop demonstrable depletion of factor V or fibrinogen. In a further patient a secondary `wave' of consumption of platelets and perhaps fibrinogen was seen late in the course of the disease. These findings confirmed the occurrence of a consumptive coagulopathy in cases of haemolytic uraemic syndrome.
对4例接受肝素持续输注治疗的溶血性尿毒症综合征患儿进行了系列凝血检查。2例无尿患者在疾病早期出现因子V和纤维蛋白原消耗,伴有血小板减少和纤维蛋白降解产物升高。这些变化在肝素治疗期间消退,且两名患者的肾功能均完全恢复。第三名患者患有轻度疾病,尿量正常,仅有临界性血小板减少,未出现可证实的因子V或纤维蛋白原消耗。在另一例患者中,在疾病后期出现了血小板和可能的纤维蛋白原消耗的继发性“波峰”。这些发现证实了溶血性尿毒症综合征病例中存在消耗性凝血病。