Prospective evaluation of three different diagnostic criteria for disseminated intravascular coagulation
Prospective evaluation of three different diagnostic criteria for disseminated intravascular coagulation
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DOI：
10.1160/th10-05-0293
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发表时间：
2011-01-01
影响因子：
6.7
通讯作者：
Nobori, Tsutomu
中科院分区：
文献类型：
--
作者：
Takemitsu, Tetsushi;Wada, Hideo;Nobori, Tsutomu
日本厚生省（JMHW）、国际血栓与止血学会（ISTH）和日本急性医学会（JAAM）建立了三种不同的弥散性血管内凝血（DIC）诊断评分系统。JMHW标准在日本仍在使用。在本研究中，所有三个诊断标准用于前瞻性评估413例患有不同基础疾病的DIC患者，这些患者在三重大学医院接受治疗（JMHW，n=166; ISTH，n=143; JAAM，n=291）。JMHW、ISHT和JAAM中死亡的比值比（95%置信区间）分别为1.88（1.22 - 2.90）、2.55（1.65 - 3.95）和1.99（1.19 - 3.32）。血小板计数、凝血酶原时间、纤维蛋白及纤维蛋白原降解产物、纤维蛋白原对DIC的诊断有重要意义。所有患者的止血分子标志物均显著升高，有助于DIC的诊断。JAAM诊断标准对DIC具有较高的敏感性，ISTH显性DIC诊断标准对DIC具有较高的特异性。DIC的所有三个诊断标准都与患者预后不良有关。
There are three different diagnostic score systems for disseminated intravascular coagulation (DIC) established by the Japanese Ministry Health and Welfare (JMHW), the International Society on Thrombosis and Haemostasis (ISTH) and the Japanese Association for Acute Medicine (JAAM). The JMHW criteria are still used in Japan. In the present study, all three diagnostic criteria were used to prospectively evaluate 413 patients with different underlying diseases of DIC who were; treated at the Mie University Hospital (JMHW, n=166; ISTH, n=143; JAAM, n=291). The odds ratio (95% confidence interval) for death was 1.88 (1.22 - 2.90) in JMHW, 2.55 (1.65 - 3.95) in ISHT and 1.99 (1.19 - 3.32)in JAAM. The platelet count, prothrombin time, fibrin and fibrinogen degradation products and fibrinogen were significantly important for diagnosis of DIC by all three diagnostic criteria. Haemostatic molecular markers were significantly high in all patients and were useful for the diagnosis of DIC. The JAAM diagnostic criteria displayed a high sensitivity for DIC and the ISTH overt-DIC diagnostic criteria displayed a high specificity for DIC. All three diagnostic criteria for DIC were related to a poor patient outcome.