Increased vascular endothelial cell markers in patients with disseminated intravascular coagulation.
We examined vascular endothelial cell markers, thrombomodulin (TM), plasminogen activator inhibitor-I (PAI-I), tissue plasminogen activator (t-PA), and von Willebrand factor, in 80 patients with disseminated intravascular coagulation (DIC). The levels of thrombin-antithrombin III complex (TAT), plasmin-alpha 2 plasmin inhibitor complex (PIC) and FDP-D-dimer were significantly increased both before and after the onset of DIC, but were not correlated with organ failure or prognosis. However, the PIC/TAT ratio was lower in patients with poor prognosis than in those with good prognosis, and it was also lower in those with organ failure than in those without. Plasma TM, PAI-I, and t-PA levels were increased in DIC patients with organ failure or poor outcome, but were not significantly increased before the onset of DIC. We consider that the prognosis of patients with DIC might be related to organ failure or endothelial cell damage and that plasma levels of TM, PAI-I, and t-PA might be useful in the detection of these disorders and in assessing prognosis. A hypofibrinolytic state might enhance organ failure in patients with DIC.
Wada
H
H
2nd Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan.
Minamikawa
K
K
Wakita
Y
Y
Nakase
T
T
Kaneko
T
T
Ohiwa
M
M
Tamaki
S
S
Deguchi
K
K
Shirakawa
S
S
Hayashi
T
T
D000933:Antifibrinolytic Agents / Q000032:analysis; D000990:Antithrombin III / Q000032:analysis; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000473:pathology; D004730:Endothelium, Vascular / Q000737:chemistry* / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005341:Fibrinolysin / Q000032:analysis; D006801:Humans; D010447:Peptide Hydrolases / Q000032:analysis; D017395:Plasminogen Activator Inhibitor 1 / Q000032:analysis* / Q000097:blood; D011379:Prognosis; D018180:Thrombomodulin / Q000032:analysis*; D010959:Tissue Plasminogen Activator / Q000032:analysis / Q000097:blood; D000979:alpha-2-Antiplasmin; D014841:von Willebrand Factor / Q000032:analysis*
D000933:Antifibrinolytic Agents; D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; D018180:Thrombomodulin; D000979:alpha-2-Antiplasmin; C046193:antithrombin III-protease complex; C037742:plasmin-plasmin inhibitor complex; D014841:von Willebrand Factor; D000990:Antithrombin III; D010447:Peptide Hydrolases; D010959:Tissue Plasminogen Activator; D005341:Fibrinolysin