Diagnostic value of hemostatic parameters in bone marrow transplant-associated thrombotic microangiopathy
Diagnostic value of hemostatic parameters in bone marrow transplant-associated thrombotic microangiopathy
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DOI：
10.1038/sj.bmt.1701151
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发表时间：
1998-04-01
影响因子：
4.8
通讯作者：
Kodama, F
中科院分区：
文献类型：
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作者：
Kanamori, H;Maruta, A;Kodama, F
我们对16例接受骨髓移植（BMT）的患者进行了一项前瞻性研究，发现移植后第14天纤维蛋白原、纤溶酶-cr、抗纤溶酶抑制剂复合物、组织纤溶酶原激活物、纤溶酶原激活物抑制剂复合物（t-PA、派）、血管性血友病因子抗原和血栓调节蛋白水平较移植前显著升高。蛋白C和凝血酶-抗凝血酶III水平没有显著变化。凝血酶原时间比值、活化部分凝血活酶时间或蛋白S无显著变化。与0- 1级GVHD患者（n = 10）相比，II-IV级GVHD患者（n = 6）在第14天显示出显著较高的t-PA.派水平。（P = 0.0062），3例II-IV级GVHD患者在第19、19和62天发生血栓性微血管病（TMA）。在这些患者中，我们注意到与未发生TMA的患者相比，在第14天纤维蛋白原水平显著降低（P = 0.0383），t-PA派（P = 0.0008）和血栓调节蛋白（P = 0.0001）水平显著升高。这些结果表明，血栓前状态和内皮损伤可能是由预处理方案和/或急性GVHD在BRIT;血栓调节蛋白值在BAIT后第14天可能是有用的监测TMA，因为内皮细胞损伤。
We investigated hemostatic parameters in a prospective study of 16 patients who received bone marrow transplants (BMT), We found a significant rise in the levels of fibrinogen, plasmin-cr, antiplasmin inhibitor complex, tissue-plasminogen activator.plasminogen activator inhibitor complex (t-PA.PAI), von Willebrand factor antigen, and thrombomodulin on day 14 after transplant compared with values before transplant. Protein C and thrombin-antithrombin III levels did not change significantly. No significant changes in prothrombin time ratio, activated partial thromboplastin time, or protein S Here detected, Patients who had grades II-IV graft-versus-host disease (GVHD) (n = 6) showed a significantly higher level of t-PA.PAI on day 14 compared with those with grades 0-I GVHD (n = 10) (P = 0.0062), Three patients with grades II-IV GVHD developed thrombotic microangiopathy (TMA) on days 19, 19 and 62. In these patients, we noted significantly lower levels of fibrinogen (P = 0.0383), and significantly higher le, els of t-PA PAI (P = 0.0008) and thrombomodulin (P = 0.0001) on day 14 compared with those patients who did not develop TMA. These results suggest that prothrombotic states and endothelial damage may be caused by the conditioning regimen and/or acute GVHD during BRIT; thrombomodulin values on day 14 post BAIT may be useful in surveillance for TMA because of endothelial cell injury.