title: Efficacy of recombinant human soluble thrombomodulin in patients with sepsis and disseminated intravascular coagulation in the gastroenterology field.
abstract: Recombinant human soluble thrombomodulin (rTM) was approved recently and has been used for treatment of disseminated intravascular coagulation (DIC). The aim of the present study was to evaluate the efficacy of rTM for DIC. The data of 53 inpatients with sepsis-induced DIC were retrospectively analyzed. Patients were classified into the rTM treatment group (n=25) and conventional treatment group (rTM not used) was the control group (n=28). Diagnosis of DIC was made according to the criteria for acute DIC of the Japan Association of Acute Medicine. Platelet count, prothrombin time-international normalized ratio, levels of fibrin/fibrinogen degradation products (FDP), C-reactive protein and DIC scores were measured on days 0, 3 and 7. Furthermore, the DIC resolution rate was assessed on days 3 and 7. Prior to treatment, DIC scores were 5.0±1.0 in the rTM group and 5.9±1.3 in the control group (P<0.05). Significant intra-group improvements were observed in all the parameters, except for FDP in the two groups. Significant improvements were observed in the DIC scores in the rTM group (Δ2.0±1.9 vs. Δ1.5±1.9, P=0.001). Therefore, the results suggest that rTM would be a useful medicine for treatment of DIC in the gastroenterology field.
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Gastroenterology, Juntendo University Shizuoka Hospital, Shizuoka 410-2295, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Nagahara
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Osada
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Kato
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Ueyama
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Saito
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Taniki
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Kanazawa
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimizu
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Jinkan
authors.initials: J
authors.lastname: Sai
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.affiliation: Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
keywords: cholangitis; disseminated intravascular coagulation; gabexate mesilate; recombinant human soluble thrombomodulin; sepsis