Diagnosis of disseminated intravascular coagulation by hemostatic molecular markers.
In the present study, the positive rate of thrombin-antithrombin complex (TAT), plasmin-plasmin inhibitor complex (PPIC), soluble fibrin monomer (sFM), and D-dimer for the diagnosis of disseminated intravascular coagulation (DIC) was evaluated. The study comprised 307 patients with DIC, 123 with pre-DIC, and 121 with non-DIC. Plasma levels of TAT, PPIC, sFM, and D-dimer were significantly higher in DIC and pre-DIC patients than in non-DIC patients. In DIC patients, the positive rate of sFM was high and that of D-dimer was low; the positive rate of PPIC was higher in patients with hematopoietic malignancy than in those without this disease. In pre-DIC patients, the positive rate of all markers was low (<0.16), and the positive rate of PPIC was relatively high. In non-DIC patients, the positive rate of all hemostatic markers was low (<0.16), that of sFM being the lowest. Scoring the positive rate of TAT, PPIC, and sFM disclosed the following results: 72% of DIC patients had three or more points, 17.6% of pre-DIC patients had three or more points, and almost all (96.6%) non-DIC patients had two or less points. Scoring the positive rate of TAT, PPIC, and D-dimer disclosed the following results: 52.9% of DIC patients and 27.4% of pre-DIC patients had three or more points and almost all (96.7%) non-DIC patients had 2 or less points. These data suggest that the combination of TAT, PPIC, and sFM is useful for making the diagnosis of DIC.
Wada
H
H
Second Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan.
Gabazza
E
E
Nakasaki
T
T
Shimura
M
M
Hiyoyama
K
K
Deguchi
K
K
Nishikawa
M
M
Sakuragawa
N
N
Shiku
H
H
D000933:Antifibrinolytic Agents / Q000032:analysis*; D000990:Antithrombin III / Q000032:analysis; D015415:Biomarkers; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000175:diagnosis*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005341:Fibrinolysin / Q000032:analysis*; D006801:Humans; D010314:Partial Thromboplastin Time; D010447:Peptide Hydrolases / Q000032:analysis; D019851:Thrombophilia / Q000097:blood / Q000175:diagnosis; D000979:alpha-2-Antiplasmin
D000933:Antifibrinolytic Agents; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D000979:alpha-2-Antiplasmin; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C011468:fibrinmonomer; C037742:plasmin-plasmin inhibitor complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D005341:Fibrinolysin