Roberts J F, Coffee G, Creel S M, Gaal A, Githens J H, Rao A R, Sundara Babu B V, Kempe C H
Bull World Health Organ. 1965;33(5):607-13.
In an investigation of specific haematological defects that might account for the haemorrhagic diathesis in certain smallpox patients, 93 patients with haemorrhagic and non-haemorrhagic forms of the disease were subjected to a variety of bleeding and coagulation studies. The findings indicate that smallpox patients with no clinical evidence of haemorrhage have no significant clotting defects although many have decreased platelets and clot retraction abnormality. Patients with the late haemorrhagic form of smallpox consistently show thrombocytopenia and associated abnormalities in the bleeding time, tourniquet test and clot retraction; some also have slightly depressed specific prothrombin activity.Patients with the severe, and uniformly fatal, early haemorrhagic form have severe thrombocytopenia, a marked decrease in specific prothrombin activity and prolongation of the prothrombin complex times. They also have a marked prolongation of the thrombin time, suggesting the presence of a circulating antithrombin.Both early and late haemorrhagic smallpox patients also have a marked abnormality of prothrombin consumption, indicating impaired plasma thromboplastin production. This finding could be explained by the thrombocytopenia present in all haemorrhagic cases.
在一项针对可能导致某些天花患者出血素质的特定血液学缺陷的调查中，93例患有出血型和非出血型天花的患者接受了各种出血和凝血研究。研究结果表明，无出血临床证据的天花患者没有明显的凝血缺陷，尽管许多患者血小板减少且血块回缩异常。晚期出血型天花患者始终表现为血小板减少以及出血时间、束臂试验和血块回缩相关异常；一些患者的特定凝血酶原活性也略有降低。严重且 uniformly fatal（此处可能有误，推测为“一致致命”）的早期出血型患者有严重的血小板减少、特定凝血酶原活性显著降低以及凝血酶原复合物时间延长。他们的凝血酶时间也显著延长，提示存在循环抗凝血酶。早期和晚期出血型天花患者的凝血酶原消耗也均有明显异常，表明血浆凝血活酶生成受损。这一发现可以用所有出血病例中存在的血小板减少来解释。
