Hypofibrinogenemia is associated with a high degree of risk in infectious diseases: a post-hoc analysis of post-marketing surveillance of patients with disseminated intravascular coagulation treated with thrombomodulin alfa.
Hypofibrinogenemia is associated with a high degree of risk in infectious diseases: a post-hoc analysis of post-marketing surveillance of patients with disseminated intravascular coagulation treated with thrombomodulin alfa.
复制标题
DOI：
10.1186/s12959-021-00264-z
复制
发表时间：
2021-02-25
影响因子：
3.1
通讯作者：
Okamoto K
中科院分区：
文献类型：
--
作者：
Kawasugi K;Wada H;Honda G;Kawano N;Uchiyama T;Madoiwa S;Takezako N;Suzuki K;Seki Y;Ikezoe T;Iba T;Okamoto K
在感染性疾病患者中，通常在没有纤维蛋白原值的情况下诊断弥散性血管内凝血 (DIC)。因此，低纤维蛋白原血症与传染病 DIC 结局之间的关系仍不清楚。我们分析了 3204 名因 DIC 和疑似 DIC 接受血栓调节蛋白α (TM-α) 治疗的患者。低纤维蛋白原血症的定义是纤维蛋白原水平<<1.5g/L。 10.3%的传染病患者出现低纤维蛋白原血症。患有低纤维蛋白原血症的感染性疾病患者，出血和器官衰竭症状的频率以及器官衰竭或DIC诊断标准的评分均显着较高，这表明在感染性疾病患者中，低纤维蛋白原血症与更进展和更严重的DIC相关。虽然合并低纤维蛋白原血症的感染性疾病患者的 28 天生存率和 DIC 缓解率均显着低于无低纤维蛋白原血症的 DIC 患者，但合并血液病的 DIC 患者却没有观察到这种差异。感染性疾病合并DIC患者的低纤维蛋白原血症可能反映了凝血反应加速导致纤维蛋白原消耗增加，而血液病合并DIC患者的低纤维蛋白原血症可能是由于纤溶亢进导致纤维蛋白原分解引起，常常导致出血和多器官功能衰竭。在线版本包含可在 10.1186/s12959-021-00264-z 获取的补充材料。
In patients with infectious diseases, disseminated intravascular coagulation (DIC) is often diagnosed without the fibrinogen value. The relationship between hypofibrinogenemia and outcomes of DIC in infectious diseases has thus remained unclear. We analyzed 3204 patients who received with thrombomodulin alfa (TM-α) for DIC and suspected DIC. Hypofibrinogenemia was defined by a fibrinogen level < 1.5 g/L. Hypofibrinogenemia was observed in 10.3% of patients with infectious diseases. The frequencies of both bleeding and organ failure symptoms, and the scores for organ failure or the DIC diagnostic criteria were significantly higher in infectious disease patients with hypofibrinogenemia, suggesting that in patients with infectious diseases, hypofibrinogenemia is associated with more progressive and severe DIC. Although the 28-day survival rate and the DIC resolution rate were both significantly lower for infectious disease patients with DIC with hypofibrinogenemia than for those without hypofibrinogenemia, this difference was not observed in DIC patients with hematological diseases. Hypofibrinogenemia among infectious disease patients with DIC may reflect increased consumption of fibrinogen due to accelerated coagulation reactions, while hypofibrinogenemia among hematological disease patients with DIC may be caused by fibrinogenolysis due to hyperfibrinolysis, and frequently results in bleeding and multiple-organ failure. The online version contains supplementary material available at 10.1186/s12959-021-00264-z.
登录
查看更多内容
影响因子：
3.1
作者：
Wada H;Takahashi H;Uchiyama T;Eguchi Y;Okamoto K;Kawasugi K;Madoiwa S;Asakura H;DIC subcommittee of the Japanese Society on Thrombosis and Hemostasis
通讯作者：
DIC subcommittee of the Japanese Society on Thrombosis and Hemostasis
影响因子：
2.9
作者：
Watanabe, R;Wada, H;Nobori, T
通讯作者：
Nobori, T
影响因子：
2.9
作者：
Iba, Toshiaki;Gando, Satoshi;Kuroda, Yasuhiro
通讯作者：
Kuroda, Yasuhiro
影响因子：
158.5
作者：
Ranieri, V. Marco;Thompson, B. Taylor;Williams, Mark D.
通讯作者：
Williams, Mark D.
DOI：
10.1186/s12941-018-0282-9
发表时间：
2018-07-09
影响因子：
5.7
作者：
Okuzono S;Ishimura M;Kanno S;Sonoda M;Kaku N;Motomura Y;Nishio H;Oba U;Hanada M;Fukushi JI;Urata M;Kang D;Takada H;Ohga S
通讯作者：
Ohga S