title: Fibrinolysis and coagulation in patients with infectious disease and sepsis.
abstract: Sepsis is often associated with hemostatic dysfunction. This study aimed to relate changes in fibrinolysis and coagulation parameters to sepsis and sepsis outcome. Urokinase-type plasminogen activator (u-PA) antigen, tissue-type plasminogen activator (t-PA) antigen and activity, plasminogen activator inhibitor (PAI) type 1 antigen, PAI activity, antithrombin (AT) III activity, and protein C activity were measured in 24 patients suffering from sepsis or septic shock and the results were compared with those observed in 30 non-sepsis patients with severe infectious disease. The u-PA level was markedly increased in plasma of sepsis patients as compared to non-sepsis patients (11.5 +/- 9.4 versus 1.6 +/- 1.5 ng/ml, p less than 0.0001). PAI-1 antigen and t-PA activity showed a significant increase in sepsis patients (320 +/- 390 ng/ml versus 120 +/- 200 ng/ml, and 3.0 +/- 3.6 IU/ml versus 1.0 +/- 0.7 IU/ml, respectively, p less than 0.01). AT III was decreased in sepsis patients (58 +/- 28% in sepsis versus 79 +/- 26% in severe infectious disease, p less than 0.01) as was protein C (30 +/- 18% versus 58 +/- 27%, p less than 0.001). No significant difference was found for t-PA antigen nor for PAI activity. Nonsurvivors of sepsis were distinguished mainly by a high u-PA antigen level and increased t-PA activity. It is concluded that plasma u-PA antigen showed the strongest significant difference, among the parameters evaluated, between sepsis and severe infection. u-PA antigen may be of prognostic value in patients admitted to the medical intensive care unit for severe infectious disease.
authors.affiliation: Department of Clinical Chemistry, University Hospital of Gent, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Philippé
authors.forename: F
authors.initials: F
authors.lastname: Offner
authors.forename: P J
authors.initials: PJ
authors.lastname: Declerck
authors.forename: G
authors.initials: G
authors.lastname: Leroux-Roels
authors.forename: D
authors.initials: D
authors.lastname: Vogelaers
authors.forename: G
authors.initials: G
authors.lastname: Baele
authors.forename: D
authors.initials: D
authors.lastname: Collen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III / Q000032:analysis; D001424:Bacterial Infections / Q000097:blood*; D001777:Blood Coagulation / Q000502:physiology*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000097:blood; D015849:Plasminogen Inactivators / Q000097:blood; D011379:Prognosis; D011486:Protein C / Q000032:analysis; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000097:blood; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood
chemical_list: D015849:Plasminogen Inactivators; D011486:Protein C; D000990:Antithrombin III; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator