Shimura M, Wada H, Wakita Y, Nakase T, Hiyoyama K, Nagaya S, Mori Y, Shiku H
Second Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Mie-ken, Japan.
Am J Hematol. 1997 Aug;55(4):169-74. doi: 10.1002/(sici)1096-8652(199707)55:4<169::aid-ajh1>3.0.co;2-q.
We measured the plasma levels of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in patients with disseminated intravascular coagulation (DIC) to examine the relationship between TFPI and vascular endothelial cell injury. Plasma TF (273 +/- 90 pg/ml) and TFPI (252 +/- 125 ng/ml) levels were significantly increased in patients with DIC compared with non-DIC patients. Plasma TF antigen level was significantly increased in pre-DIC patients (285 +/- 85 pg/ml), while the plasma TFPI level (152 +/- 54 ng/ml) was not markedly increased in such a state. The plasma TF/TFPI ratio was high in the pre-DIC patients (2.10 +/- 0.90), and low in the DIC patients (1.40 +/- 0.87) and healthy volunteers (0.84 +/- 0.26). There was no significant difference between the DIC patients with a good outcome and those with a poor outcome in terms of plasma TF levels, although the plasma TFPI level in the DIC patients with a good outcome (289 +/- 133 ng/ml) was significantly higher than those with a poor outcome (187 +/- 75 ng/ml). During the clinical course of DIC, plasma TF antigen was increased first, and an increase of the plasma TFPI level followed the increase in plasma TF level. These findings suggest that plasma TFPI is released from vascular endothelial cells and it may reflect vascular endothelial cell injury. It is conceivable that TF and TFPI may play an important role in the onset of DIC.
我们检测了弥散性血管内凝血（DIC）患者血浆中组织因子（TF）和组织因子途径抑制物（TFPI）的水平，以研究TFPI与血管内皮细胞损伤之间的关系。与非DIC患者相比，DIC患者血浆TF（273±90 pg/ml）和TFPI（252±125 ng/ml）水平显著升高。DIC前期患者血浆TF抗原水平显著升高（285±85 pg/ml），而在此状态下血浆TFPI水平（152±54 ng/ml）未明显升高。DIC前期患者血浆TF/TFPI比值较高（2.10±0.90），DIC患者（1.40±0.87）和健康志愿者（0.84±0.26）该比值较低。DIC患者中预后良好者与预后不良者的血浆TF水平无显著差异，尽管预后良好的DIC患者血浆TFPI水平（289±133 ng/ml）显著高于预后不良者（187±75 ng/ml）。在DIC的临床过程中，血浆TF抗原首先升高，随后血浆TFPI水平随血浆TF水平升高而升高。这些发现提示血浆TFPI从血管内皮细胞释放，可能反映血管内皮细胞损伤。可以推测TF和TFPI在DIC的发生中可能起重要作用。
