Bick R L
University of Texas Southwestern Medical Center and Dallas Thrombosis Hemostasis Clinical Center, USA.
Semin Thromb Hemost. 1998;24(1):3-18. doi: 10.1055/s-2007-994971.
Current concepts of the many complex pathophysiological mechanisms and clinical and laboratory manifestations of disseminated intravascular coagulation (DIC) are presented. Considerable attention has been devoted to interrelationships within the hemostasis system. Only by clearly understanding these extraordinarily complex pathophysiological interrelationships can the clinician and laboratory scientist appreciate the divergent and wide spectrum of often confusing clinical and laboratory findings in patients with DIC. Many therapeutic decisions are controversial and will remain so until more is published about specific therapeutic modalities and survival patterns. The future holds promise for not only newer antithrombotic agents, but also agents which will block, blunt or modify cytokine activity and the activity of vasoactive substances. Also, therapy must be highly individualized depending on the nature of DIC, age, etiology of DIC, site and severity of hemorrhage or thrombosis and hemodynamic and other clinical parameters.
本文介绍了弥散性血管内凝血（DIC）复杂的病理生理机制、临床表现及实验室检查结果的最新概念。止血系统内部的相互关系受到了广泛关注。只有清楚地了解这些极其复杂的病理生理相互关系，临床医生和实验室科学家才能理解DIC患者常常令人困惑的、多样且广泛的临床和实验室检查结果。许多治疗决策存在争议，在有更多关于特定治疗方式和生存模式的报道之前，这种情况仍将持续。未来不仅有望出现更新的抗血栓药物，还会有能够阻断、抑制或改变细胞因子活性以及血管活性物质活性的药物。此外，治疗必须高度个体化，这取决于DIC的性质、年龄、DIC的病因、出血或血栓形成的部位和严重程度以及血流动力学和其他临床参数。
