[Adequate parameters for the diagnosis of disseminated intravascular coagulation (DIC) in patients with liver diseases].
Despite of many investigations addressing the problem on the diagnosis of DIC associated with liver diseases, however, an adequate clinical and laboratory criteria has not yet been established. We attempted to clarify this problem by evaluating the changes of plasma levels of PIC, D dimer, TAT and several endothelial factors in 20 patients with severe liver disease who had the evidence of hemorrhage, and were treated with AT III concentrate and gabexate mesilate (FOY). In patients who show a good response to treatment, plasma levels of PIC and D dimer before treatment were both significantly higher (p < 0.01) than those in patients who did not respond, while there was no significant difference in other coagulation fibrinolysis parameters except for platelet count which showed rather lower in the response group (p < 0.05). We believe that combination assay for both PIC and D dimer will be adequate to differentiate whether the hemostatic abnormalities are induced mainly by DIC or hepatic insufficiency.
Second Department of Internal Medicine, St. Marianna University School of Medicine.
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S
Iwabuchi
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M
Takatori
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K
Okabe
D000328:Adult; D000990:Antithrombin III / Q000032:analysis / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D016670:Gabexate / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D008107:Liver Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000032:analysis; D017395:Plasminogen Activator Inhibitor 1 / Q000032:analysis; D011956:Receptors, Cell Surface / Q000032:analysis; D018179:Receptors, Thrombin; D010959:Tissue Plasminogen Activator / Q000032:analysis
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; D011956:Receptors, Cell Surface; D018179:Receptors, Thrombin; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D016670:Gabexate; D000990:Antithrombin III; D010447:Peptide Hydrolases; D010959:Tissue Plasminogen Activator