Tran T H, Lämmle B, Duckert F
Am J Clin Pathol. 1984 Nov;82(5):565-72. doi: 10.1093/ajcp/82.5.565.
C, VIII:CAg, VIIIR:Ag and VIIIR:Cof were determined repeatedly in nine shock patients with suspected DIC and in five patients with uncomplicated acute myocardial infarction and compared with the clinical course and the severity of DIC as reflected by a score based on six routine coagulation and fibrinolysis parameters. All shock patients showed high levels of VIIIR:Ag, VIIIR:Cof, and VIII:CAg, averaging fivefold to sixfold the normal level, of VIII:C averaging threefold the normal level. VIIIR:Cof and VIIIR:Ag significantly correlated in both groups of patients. In shock patients, VIII:C values were lower than VIII:CAg and varied between 40-90% of VIII:CAg. There were significant negative correlations between the DIC score on the one hand and ratios of VIII:C/VIIIR:Ag, VIII:C/VIII:CAg, and VIII:CAg/VIIIR:Ag on the other. The two patients who died from irreversible shock had the highest DIC score and lowest ratios of VIII:C/VIIIR:Ag and VIII:CAg/VIIIR:Ag as well as VIII:C/VIIIR:Cof and VIII:CAg/VIIIR:Cof. Released VIIIR:Ag multimers possess the ristocetin cofactor activity. In DIC, VIII:CAg is partially proteolyzed, however, less than VIII:C. The quotient VIII:C/VIIIR:Cof or VIII:C/VIIIR:Ag is a good indicator of the severity of DIC and may have important prognostic value.
对9名疑似弥散性血管内凝血（DIC）的休克患者和5名无并发症的急性心肌梗死患者反复测定VIII因子促凝活性（VIII:C）、VIII因子抗原（VIII:CAg）、血管性血友病因子抗原（VIIIR:Ag）和血管性血友病因子相关抗原（VIIIR:Cof），并与基于6项常规凝血和纤维蛋白溶解参数的评分所反映的DIC临床病程和严重程度进行比较。所有休克患者的VIIIR:Ag、VIIIR:Cof和VIII:CAg水平均较高，平均为正常水平的5至6倍，VIII:C平均为正常水平的3倍。两组患者中，VIIIR:Cof和VIIIR:Ag显著相关。在休克患者中，VIII:C值低于VIII:CAg，为VIII:CAg的40%至90%。一方面，DIC评分与VIII:C/VIIIR:Ag、VIII:C/VIII:CAg和VIII:CAg/VIIIR:Ag比值之间存在显著负相关。死于不可逆休克的两名患者DIC评分最高，VIII:C/VIIIR:Ag、VIII:CAg/VIIIR:Ag以及VIII:C/VIIIR:Cof和VIII:CAg/VIIIR:Cof比值最低。释放的VIIIR:Ag多聚体具有瑞斯托霉素辅因子活性。在DIC中，VIII:CAg部分被蛋白水解，但程度低于VIII:C。VIII:C/VIIIR:Cof或VIII:C/VIIIR:Ag比值是DIC严重程度的良好指标，可能具有重要的预后价值。
