Takahashi H, Sato N, Shibata A
Blood Transfusion Division, Niigata University Medical Hospital, Japan.
Thromb Res. 1995 Nov 15;80(4):339-48. doi: 10.1016/0049-3848(95)00185-t.
In order to assess the clinical implication of tissue factor pathway inhibitor (TFPI) in disseminated intravascular coagulation (DIC), plasma concentrations of TFPI were measured together with plasma tissue factor (TF) in 30 healthy subjects and 49 patients with DIC associated with a variety of underlying diseases. The mean TFPI concentration was elevated in patients with DIC at presentation (205.8 +/- SD 79.1 ng/ml) as compared with healthy subjects (97.3 +/- 22.2 ng/ml, P < 0.001). The mean plasma TF concentration in patients with DIC (412.7 +/- 445.7 pg/ml) was also higher than that in healthy subjects (137.5 +/- 50.6 pg/ml, P < 0.001). Elevated TF levels were found predominantly in patients with DIC caused by cancer and leukemia, whereas TFPI was elevated in all underlying disease categories. Plasma TFPI concentration did not correlate with plasma TF. In addition, hemostatic markers of DIC such as thrombin-antithrombin complex, prothrombin fragment 1 + 2, plasmin-plasmin inhibitor complex, FDP or fibrinogen did not correlate with TFPI. Serial determinations of plasma TFPI in each patient demonstrated that the behavior of TFPI was independent of the changes in plasma TF and other hemostatic parameters. These findings indicate that plasma TFPI does not decrease in DIC and is not valuable for monitoring the progress of DIC.
为了评估组织因子途径抑制剂（TFPI）在弥散性血管内凝血（DIC）中的临床意义，我们检测了30名健康受试者以及49例患有各种基础疾病并发DIC患者的血浆TFPI浓度，并同时检测了血浆组织因子（TF）浓度。与健康受试者（97.3±22.2 ng/ml，P<0.001）相比，DIC患者就诊时的平均TFPI浓度升高（205.8±标准差79.1 ng/ml）。DIC患者的平均血浆TF浓度（412.7±445.7 pg/ml）也高于健康受试者（137.5±50.6 pg/ml，P<0.001）。TF水平升高主要见于癌症和白血病所致DIC患者，而TFPI在所有基础疾病类型中均升高。血浆TFPI浓度与血浆TF不相关。此外，DIC的止血标志物如凝血酶-抗凝血酶复合物、凝血酶原片段1+2、纤溶酶-纤溶酶抑制剂复合物、FDP或纤维蛋白原与TFPI均不相关。对每位患者的血浆TFPI进行连续测定表明，TFPI的变化与血浆TF及其他止血参数的变化无关。这些发现表明，DIC时血浆TFPI不降低，对监测DIC的进展无价值。
