[Diagnosis of disseminated intravascular coagulation: the value of soluble fibrin, D-dimers and fibrin(ogen) split products].
The validity of the fibrin(ogen) derivatives 'soluble fibrin, D-dimers and fibrin(ogen) degradation products' was compared with other parameters in early and sensitive diagnosing of disseminated intravascular coagulation (DIC). In a clinical study 900 patients' samples from separate, defined groups were examined, including course observations of intensive care patients (n = 38) and patients with acute pancreatitis. The fibrin(ogen) derivatives correlated very well with the degree of blood coagulation disturbances: in particular, D-dimers and soluble fibrin proved to be more sensitive in early diagnosis of DIC than other parameters. The SF-PS-turbidimetry demonstrated a good validity and practicality in the quantitative determination of soluble fibrin, but a suitable analyzer is essential. Determination of D-dimers is preferable to that of fibrin(ogen) degradation products (both in the latex-agglutination test) because of the better sensitivity and practicality; even more sensitive results were provided by the D-dimer-ELISA, which is, however, not practical in acute diagnostics. The decrease in protein C was at least equally sensitive as the antithrombin III-levels in indicating the consumption of the hemostatic potential. The decrease of thrombocyte counts and fibrinogen levels could first be detected in a later stage of DIC. In conclusion, D-dimers and soluble fibrin can improve the DIC diagnostics, making them more reliable; additionally, antithrombin III and possibly protein C deserve further consideration, although the fibrin(ogen) derivatives are apparently of greater importance.
Haematologie, Universitätsklinikum, Göttingen.
J U
JU
Wieding
G
G
Eisinger
H
H
Köstering
D000208:Acute Disease; D000990:Antithrombin III / Q000097:blood; D001780:Blood Coagulation Tests; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000175:diagnosis*; D005337:Fibrin / Q000032:analysis*; D005338:Fibrin Fibrinogen Degradation Products / Q000097:blood*; D006801:Humans; D010195:Pancreatitis / Q000150:complications; D010976:Platelet Count; D011486:Protein C / Q000097:blood
D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; C036309:fibrin fragment D; D000990:Antithrombin III; D005337:Fibrin
Diagnostik der disseminierten intravasalen Gerinnung: Aussagekraft von löslichem Fibrin, D-Dimeren und Fibrin(ogen)-Spaltprodukten.