CHANGES IN BLOOD COAGULATION SYSTEM ASSOCIATED WITH SEPTICEMIA
CHANGES IN BLOOD COAGULATION SYSTEM ASSOCIATED WITH SEPTICEMIA
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DOI：
10.1056/nejm196810172791603
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发表时间：
1968-01-01
影响因子：
158.5
通讯作者：
MAY, N
中科院分区：
文献类型：
--
作者：
CORRIGAN, JJ;RAY, WL;MAY, N
对36例败血症患儿进行的详细凝血分析显示，22例革兰氏阴性和8例革兰氏阳性感染，2例落基山斑疹热，4例未分离出病原体。凝血机制的各种变化与感染原无关，但显然与血压有关。最常见的单一异常是血小板减少症，占所有病例的61%。在低血压或休克患者中经常观察到的多种凝血变化被解释为继发于弥漫性血管内凝血。在血压正常的病例中没有看到类似的变化。最可靠的实验室指南似乎是血小板计数减少，血浆中的低因子V水平和血清中的纤维蛋白溶解分裂产物。所有怀疑有缺陷的低血压患者均给予肝素治疗。大多数败血症和低血压患者明显存在该缺陷。
Detailed coagulation analyses in 36 pediatric cases of septicemia revealed 22 gram-negative and eight gram-positive infections, two Rocky Mountain spotted fevers, and four with no etiologic agent isolated. Various changes in the clotting mechanism were encountered irrespective of the infectious agent but apparently related to blood pressure. The most frequent single abnormality was thrombocytopenia in 61 per cent of all cases. Multiple coagulation changes, regularly noted in patients with hypotension or shock, were interpreted as being secondary to diffuse intravascular coagulation. Similar changes were not seen in cases with normal blood pressures. The most reliable laboratory guides seemed to be a reduced platelet count, low factor V levels in plasma and fibrinolytic split products in serum. Heparin was given in all patients with hypotension suspected of having the defect. Most patients with septicemia and low blood pressure apparently have the defect.