Weltermann A, Mitterbauer G J, Mitterbauer M, Hattey E, Speiser W, Gisslinger H, Knöbl P, Eichinger S
Abteilung für Hämatologie/Hämostaseologie, Universitätsklinik Innere Medizin I, Osterreich.
Wien Klin Wochenschr. 1998 Jan 30;110(2):53-7.
We report on a 64-year-old patient with a recurrent endometrial carcinoma which was associated with disseminated intravascular coagulation (DIC) and excessive hyperfibrinolysis. The patient presented with severe bleeding due to hypofibrinogenemia. Fibrin degradation products were excessively elevated and there were also increased levels of activation markers of coagulation. Free plasmin was demonstrated in the circulation and alpha 2-antiplasmin was almost completely depleted. No increase in t-PA or u-PA level was demonstrated. Antifibrinolytic treatment led to a decrease of fibrin degradation products, but to an increase of activation markers of coagulation and was not associated with an increase of fibrinogen. Combination chemotherapy led to a rapid decrease of activation markers of coagulation and a sustained increase of fibrinogen. The beneficial effects on DIC/hyperfibrinolysis occurred despite the absence of any measurable effect of chemotherapy on the tumour. The patient finally died due to progression of the tumour, but without recurrence of the DIC/hyperfibrinolysis.
我们报告了一例64岁复发性子宫内膜癌患者，该患者伴有弥散性血管内凝血（DIC）和过度的纤维蛋白溶解亢进。患者因纤维蛋白原血症而出现严重出血。纤维蛋白降解产物过度升高，凝血活化标志物水平也升高。循环中检测到游离纤溶酶，α2-抗纤溶酶几乎完全耗尽。未发现组织型纤溶酶原激活物（t-PA）或尿激酶型纤溶酶原激活物（u-PA）水平升高。抗纤溶治疗导致纤维蛋白降解产物减少，但凝血活化标志物增加，且与纤维蛋白原增加无关。联合化疗导致凝血活化标志物迅速下降，纤维蛋白原持续增加。尽管化疗对肿瘤没有任何可测量的影响，但对DIC/纤维蛋白溶解亢进仍产生了有益效果。患者最终因肿瘤进展死亡，但未出现DIC/纤维蛋白溶解亢进复发。
