Downey C, Kazmi R, Toh C H
Department of Haematology, Royal Liverpool University Hospital, UK.
Thromb Haemost. 1998 Jul;80(1):65-9.
Efforts to improve the prognosis in disseminated intravascular coagulation (DIC) have been hampered by the lack of an early, useful and rapidly available diagnostic marker. More recently, a characteristic bi-phasic change in the light transmittance waveform profile of the APTT assay has been associated with DIC. In this prospective study, we have assessed the utility of this assay in the routine clinical setting. 1,470 samples were analysed from 747 patients and 41 patients had DIC. The sensitivity and specificity of the bi-phasic waveform pattern for DIC was 97.6% and 98% respectively. The appearance of a bi-phasic waveform preceded the development of abnormalities in the standard laboratory tests for DIC and waveform changes correlated closely with clinical events. In conclusion, transmittance waveform analysis is not only useful as an early diagnostic and single monitoring marker of DIC but the quantifiable and standardisable changes also allow for prognostic applicability in clinical management.
由于缺乏早期、实用且能快速获得的诊断标志物，改善弥散性血管内凝血（DIC）预后的努力受到了阻碍。最近，活化部分凝血活酶时间（APTT）测定的透光率波形特征性双相变化与DIC相关。在这项前瞻性研究中，我们评估了该测定在常规临床环境中的实用性。对747例患者的1470份样本进行了分析，其中41例患有DIC。DIC双相波形模式的敏感性和特异性分别为97.6%和98%。双相波形的出现先于DIC标准实验室检查异常的出现，且波形变化与临床事件密切相关。总之，透光率波形分析不仅作为DIC的早期诊断和单一监测标志物有用，而且可量化和标准化的变化也使其在临床管理中具有预后适用性。
