Wuillemin W A, Fijnvandraat K, Derkx B H, Peters M, Vreede W, ten Cate H, Hack C E
Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Amsterdam, The Netherlands.
Thromb Haemost. 1995 Dec;74(6):1436-41.
Meningococcal septic shock (MSS) is complicated by activation of coagulation, fibrinolytic, and complement systems. We studied the contact system of the intrinsic pathway of coagulation in thirteen children with MSS. Activation was assessed upon admittance to the intensive care unit and 48 h thereafter, based on the measurement of factor XII- (FXII), prekallikrein- and factor XI (FXI) antigen levels, as well as on the detection of FXIa-FXIa inhibitor, FXIIa-C1-inhibitor, and kallikrein-C1-inhibitor complexes, respectively. Levels of FXII, prekallikrein and FXI were reduced to about 50% in all patients on admission, and were significantly higher 48 h later. FXIIa-C1-inhibitor complexes were elevated in 7 patients, and kallikrein-C1-inhibitor complexes in 2 patients. FXIa-alpha 1-antitrypsin complexes were elevated in all patients, FXIa-C1-inhibitor complexes in nine, and FXIa-antithrombin III complexes in one patient. We conclude that patients with MSS have activation of the contact system, which may contribute to activation of coagulation, and thus to morbidity and mortality.
脑膜炎球菌性败血症（MSS）会因凝血、纤溶和补体系统的激活而变得复杂。我们研究了13例MSS患儿凝血内源性途径的接触系统。在重症监护病房入院时及此后48小时进行激活评估，分别基于凝血因子 XII-（FXII）、前激肽释放酶和凝血因子 XI（FXI）抗原水平的测量，以及FXIa-FXIa抑制剂、FXIIa-C1抑制剂和激肽释放酶-C1抑制剂复合物的检测。所有患者入院时FXII、前激肽释放酶和FXI水平降至约50%，48小时后显著升高。7例患者的FXIIa-C1抑制剂复合物升高，2例患者的激肽释放酶-C1抑制剂复合物升高。所有患者的FXIa-α1抗胰蛋白酶复合物升高，9例患者的FXIa-C1抑制剂复合物升高，1例患者的FXIa-抗凝血酶III复合物升高。我们得出结论，MSS患者存在接触系统激活，这可能导致凝血激活，进而导致发病和死亡。
