Wada H, Minamikawa K, Wakita Y, Nakase T, Kaneko T, Ohiwa M, Tamaki S, Deguchi A, Mori Y, Deguchi K
2nd Department of Internal Medicine, College of Medical Science, Mie University School of Medicine, Tsu-city, Japan.
Am J Hematol. 1993 Jul;43(3):190-4. doi: 10.1002/ajh.2830430306.
Early diagnosis is necessary for the treatment of disseminated intravascular coagulation (DIC), but criteria for the stage preceding the diagnosis of DIC (pre-DIC) have not yet been established. To clarify hemostatic abnormalities that occur before the onset of DIC, we performed hemostatic studies in 117 patients within at least a week before the onset of DIC (pre-DIC), in 237 patients with DIC, and in 50 patients without DIC or pre-DIC (non-DIC). Levels of FDP, PT, and fibrinogen, and platelet counts were significantly abnormal after the onset of DIC, but not before. Thrombin-antithrombin III complex (TAT), plasmin-alpha 2 plasmin inhibitor complex (PIC), and FDP-D-dimer levels were significantly higher before the onset of DIC compared to the non-DIC patients. Hemostatic abnormalities were observed within a week before the onset of DIC. Monitoring the plasma levels of TAT, PIC, and FDP-D-dimer might be useful for the diagnosis of a pre-DIC condition.
早期诊断对于弥散性血管内凝血（DIC）的治疗至关重要，但DIC诊断前阶段（前DIC）的标准尚未确立。为了阐明DIC发作前出现的止血异常，我们对117例在DIC发作前至少一周内（前DIC）的患者、237例DIC患者以及50例无DIC或前DIC（非DIC）的患者进行了止血研究。DIC发作后，纤维蛋白降解产物（FDP）、凝血酶原时间（PT）、纤维蛋白原水平及血小板计数显著异常，但发作前无异常。与非DIC患者相比，DIC发作前凝血酶 - 抗凝血酶III复合物（TAT）、纤溶酶 - α2纤溶酶抑制物复合物（PIC）及FDP - D - 二聚体水平显著升高。在DIC发作前一周内观察到止血异常。监测血浆TAT、PIC及FDP - D - 二聚体水平可能有助于前DIC状态的诊断。
