The valuable diagnosis of DIC and pre-DIC and prediction of a poor outcome by the evaluation of diagnostic criteria for DIC in patients with hematopoietic injury established by the Japanese Society of Thrombosis and Hemostasis
The valuable diagnosis of DIC and pre-DIC and prediction of a poor outcome by the evaluation of diagnostic criteria for DIC in patients with hematopoietic injury established by the Japanese Society of Thrombosis and Hemostasis
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DOI：
10.1016/j.thromres.2016.09.028
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发表时间：
2016-11-01
影响因子：
7.5
通讯作者：
Katayama, Naoyuki
中科院分区：
文献类型：
--
作者：
Aota, Takumi;Wada, Hideo;Katayama, Naoyuki
目的：对274例疑似DIC并造血系统损伤的患者采用日本血栓与止血学会（JSTH）公布的弥散性血管内凝血（DIC）诊断标准进行评价。材料与方法：DIC 125例，DIC前期42例，非DIC 107例。采用受试者工作特征（ROC）分析评价DIC诊断标准的有效性。全凝血试验（GCT）评分诊断“DIC”的曲线下面积（ARC）和比值比（odd's ratio）高，而诊断“DIC和DIC前期”的曲线下面积（ARC）和比值比低，提示需要添加抗凝血酶（AT）和可溶性纤维蛋白（SF）/凝血酶抗凝血酶复合物（达特）来诊断“DIC和前DIC”。虽然除了AT和SF/达特值的GCT并没有增加其预测不良结局的能力，JSTH的修改诊断标准评分与死亡的比值比相关。讨论和结论：JSTH的修改DIC的诊断标准，其中包括GCT评分，AT，和达特/SF值，是有用的诊断DIC和前DIC，并预测不良结局。(C)2016爱思唯尔有限公司版权所有。
Objective: We evaluated the modified diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH), in 274 suspected DIC patients with hematopoietic injury.Materials and methods: The diagnoses of the patients were as follows: DIC (n=125); pre-DIC (n=42) and non-DIC (n=107). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver operating characteristic (ROC) analysis.Results: The area under the curve (ARC) and odd's ratio for the global coagulation test (GCT) scores in the diagnosis of "DIC" were high, while those for the diagnosis of "DIC and pre-DIC" were low, suggesting that the addition of antithrombin (AT) and soluble fibrin (SF)/thrombin antithrobin complex (TAT) was required to diagnose "DIC and pre-DIC". Although the addition of the AT and SF/TAT values to the GCT did not increase its ability to predict a poor outcome, the JSTH's modified diagnostic criteria scores were correlated with the odds ratio for death.Discussion and conclusion: The JSTH's modified diagnostic criteria for DIC, which included the GCT score, and the AT, and TAT/SF values, were useful for diagnosing DIC and pre-DIC, and predicting a poor outcome. (C) 2016 Elsevier Ltd. All rights reserved.