A prospective comparison of new Japanese criteria for disseminated intravascular coagulation: New Japanese criteria versus ISTH criteria
A prospective comparison of new Japanese criteria for disseminated intravascular coagulation: New Japanese criteria versus ISTH criteria
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DOI：
10.1177/1076029606299077
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发表时间：
2007-04-01
影响因子：
2.9
通讯作者：
Hoshino, Hirokatsu
中科院分区：
文献类型：
--
作者：
Hayakawa, Mineji;Gando, Satoshi;Hoshino, Hirokatsu
在日本，基于旧日本标准的弥散性血管内凝血（DIC）的早期诊断和早期治疗大大改善了血液系统恶性肿瘤DIC患者的结局。然而，危重患者的DIC的预后仍然很差。为了克服这种情况，日本于2002年制定了新的危重患者DIC标准。新的日本DIC标准采用了与全身炎症反应综合征相关的凝血功能障碍的概念。在本研究中，我们前瞻性地研究了新标准与器官衰竭、预后和其他DIC标准之间的关系。本研究纳入了74例血小板计数低于150 x 10（9）/L的患者。一旦患者被纳入研究，从第0天至第4天记录每日DIC评分和序贯器官衰竭评估评分。新的日本DIC标准诊断DIC早于非显性DIC和旧的日本标准（P =.0005）。新的日本标准在建立多器官功能衰竭之前诊断出更多DIC患者（P = 0.023）。新的日本标准也倾向于比其他两套更有效地预测中风。总之，新日本标准的诊断敏感性与非显性DIC标准一样高。此外，新的日本标准在DIC标准集中提供了最早的检测和最准确的结果预测。
In Japan, early diagnosis and early treatment of disseminated intravascular coagulation (DIC) based on the old Japanese criteria have greatly improved the outcomes of DIC patients with hematopoietic malignancy. However, the prognoses of critically ill patients with DIC have remained poor. To overcome this situation, new Japanese DIC criteria for critically ill patients were established in 2002. The new Japanese DIC criteria adopted a concept of coagulopathy associated with systemic inflammatory response syndrome. In the present study, we prospectively investigated the relationships between the new criteria and organ failure, prognosis, and other sets of DIC criteria. This study included 74 patients whose platelet counts were below 150 x 10(9)/L. Daily DIC scores and sequential organ failure assessment scores were recorded from days 0 to 4 once the patient was included in the study. The new Japanese DIC criteria diagnosed DIC earlier than both the non-overt DIC and the old Japanese criteria did (P =.0005). The new Japanese criteria diagnosed more DIC patients prior to the establishment of multiple organ failure than the other sets (P =.023). The new Japanese criteria tended also to predict prognoses more efficiently than the other two sets. in conclusion, the diagnostic sensitivity of the new Japanese criteria was as high as that of the non-overt DIC criteria. Furthermore, the new Japanese criteria provided the earliest detection and most accurate outcome prediction of DIC among the DIC criteria sets.