Blood coagulation and fibrinolytic factors as well as their inhibitors in trauma.
Blood coagulation and fibrinolytic factors as well as their inhibitors in trauma.
复制标题
创伤中的凝血和纤溶因子及其抑制剂。
DOI：
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发表时间：
1985
期刊：
影响因子：
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通讯作者：
J. Swedenborg
中科院分区：
文献类型：
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作者：
M. Blombäck;J. Eklund;M. Hellgren;M. Lagerkranser;J. Swedenborg
在13例多发性创伤患者中评价了诊断DIC的公认试验。在入院时抽取血液样本，然后使用血液、血液制品或肝素进行治疗。试验包括血小板计数、凝血酶原复合物（Normotest/Thrombotest）、因子V、因子VIII：C、纤维蛋白原、纤维蛋白原降解产物（FDP）、凝血酶和立止血时间以及乙醇凝胶试验（纤维蛋白单体）。根据检查结果，将患者分为DIC组、疑似DIC组和无DIC组。结果发现，那些被转介到DIC组的患者也是那些后来发展出最严重的器官功能障碍和在重症监护室停留时间最长的患者。因此，临床和实验室结果一致。Normotest/Thrombotest比值、凝血酶时间和立止血时间以及纤维蛋白单体的存在对DIC的诊断价值有限。为了做出正确的诊断，必须将几种常规测试的结果结合起来。然后评价了其他试验。所有DIC患者的纤维蛋白肽A（FPA）水平和凝血因子VIII：Ag（vWF：Ag）/凝血因子VIII：C比值升高以及部分DIC患者的抗凝血酶（AT）水平降低表明凝血酶活性和血栓栓塞事件的风险。纤溶酶原和α 2-抗纤溶酶的减少表明纤溶系统的激活。它的结论是，这些新的测试是有用的DIC和类似的蛋白水解状态的诊断和治疗。
Tests generally accepted in the diagnosis of DIC were evaluated in 13 patients with multiple trauma. The blood samples were drawn on admission before treatment with blood, blood products or heparin. The tests included platelet count, prothrombin complex (Normotest/Thrombotest), Factor V, Factor VIII:C, fibrinogen, fibrinogen degradation products (FDP), thrombin and Reptilase times as well as the ethanol gelation test (fibrin monomer). Based on the results of the tests, the patients were categorized into DIC, suspected DIC and no DIC groups. It was found that those patients who were referred to the DIC group were also those who later developed the most severe organ dysfunction and who stayed the longest time in the Intensive Care Unit. Thus, the clinical and laboratory findings agreed. The Normotest/Thrombotest ratio, thrombin times and Reptilase times, and presence of fibrin monomers were of limited value for the diagnosis of DIC. To make a correct diagnosis, the results of several of the conventional tests had to be combined. Additional tests were then evaluated. An increase of the fibrinopeptide A (FPA) level and the Factor VIIIR:Ag (vWF:Ag)/Factor VIII:C ratio in all the DIC patients as well as a decrease of the antithrombin (AT) level in some DIC patients indicated thrombin activity and a risk of thromboembolic events. A decrease of plasminogen and alpha 2-antiplasmin indicated activation of the fibrinolytic system. It is concluded that these new tests are useful in the diagnosis and treatment of DIC and similar proteolytic states.