細管内凝固過程における血液粘度とCPC像の変動
1978 年 9 巻 4 号 p. 538-543
詳細
1978 年 9 巻 4 号 p. 538-543
Intratubular coagulation study, as in vitro model experiment of disseminated intravascular coagulation (DIC), and a case study of a patient with DIC, were performed for effects of the blood viscosity and the hemolytic pattern by coil planet centrifuge (CPC) on DIC.
The time changes of blood viscosity and hemolytic pattern by CPC, together with partial thromboplastin time (PTT), prothrombin time (PT), platelet counts, fibrinogen level and some hematological test were observed during coagulation process of flowing blood in small polyethylene tube (diameter 0.5mm).
The PTT gradually shortened after 10, 20, 30min. flowing respectively, but prolonged after 40min., and the blood in tube completely coagulated after 50min. flowing. The PT prolongedd after 20min., and extremely prolonged after 40min. flowing in small tube. Platelet counts and fibrinogen level were gradually reduced according to the progress of coagulation process, and showed nearly 0 after 50min. Namely, intratubular coagulation resembled closely DIC, though was not so effective on the enhancement of fibrinolysis.
On the relation of blood viscosity to hematocrit (Ht) level, there was a sharp increase in viscosity with increase in Ht level. The blood viscosity in intratubular coagulation process gradually increased till 30min. after flowing, when PTT was the shortest, but the viscosity thereafter decreased gradually in accordance with the prolongation of PTT and the decrease of fibrinogen and Ht level.
Hemolytic pattern by CPC showed specific waving curve after 20min. to 30min. flowing, and then extention of hemolysis with poikylocytosis in red blood cells.
On the case study of post hepatectomy with DIC, the blood viscosity increased in stage of hypercoagulability, decreased in period of consumption coagulopathy or with heparin therapy. The hemolytic pattern by CPC showed waving curve in hypercoagulable state, wide low curve in consumption coagulopathy and normal pattern with heparin therapy.
It was considered that measurements of blood viscosity and observation of hemolytic pattern by CPC had clinical significance for diagnosis of hypercoagulable state in early DIC, and prognosis of DIC.
